Outcomes and complications of cataract surgery in patients with chronic ocular graft-versus-host-disease—a multicenter, retrospective analysis

• DOI: 10.1007/s00417-022-05613-w
• Publication Date: 2022-03-07T09:02:57Z
• Authors: Uta Gehlsen; Christiane Faust; Christiane Blecha; Tina Dietrich-Nto...; Philipp Eberwein; Susanne Issleib; Tobias Meyer-ter-...; Regine Braun; Henrike Westekemper; Philipp Steven
• Keywords: ddc:610; Phacoemulsification; Corneal Perforation; Medizin; 610 Medizin; 610; Graft vs Host Disease; Cataract; Macular Edema; 3. Good health; Cornea; BONE-MARROW-TRANSPLANTATION; CONSENSUS DEVELOPMENT PROJECT; TOTAL-BODY IRRADIATION; QUALITY-OF-LIFE; DRY EYE; CORNEAL PERFORATION; CLINICAL-TRIALS; PHACOEMULSIFICATION; DIAGNOSIS; SEVERITY; Graft-versus-host-disease; Cataract; Phacoemulsification; Complication; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Humans; Retrospective Studies

Abstract Purpose To evaluate the outcome of phacoemulsification in patients with chronic ocular Graft-versus-host disease (oGVHD) after allogeneic hematopoietic stem cell transplantation (aHSCT). Methods Retrospective, observational multicenter study from 1507 oGVHD patients. From patient files, data were collected including best-corrected visual acuity (BCVA), intraocular pressure (IOP), Schirmer’s test I , tear film break-up time (TFBUT), corneal fluorescein staining score, postoperative complications, and pre- post-operative topical therapy. Results Seventy-three underwent cataract surgery 104 eyes. In n = 84 eyes, NIH grade was documented; 12% ( 12) analyzed eyes staged 1, 31% 32) 2 39% 41) 3. The mean BCVA improved 82% 86 eyes). significantly increased 0.7 ± 0.5 to 0.4 LogMAR independent severity. IOP decreased 14 4 13 mmHg surgery. Visual moderately correlated pre-operative degree (Pearson p 0.26, 0.002, Cohen’s effect size f 0.29). by 0.078 LogMar units (95% CI 0.027–0.141) each increase one 0.05). After surgery, epitheliopathy 42% 44) Postoperative complications included perforation 6, 6%), cystoid macular edema 4, 4%), endophthalmitis 1%). Conclusion Phacoemulsification improves acuity, but is associated an risk particular perforations.