Gehlsen, Uta and Faust, Christiane and Blecha, Christiane and Dietrich-Ntoukas, Tina and Eberwein, Philipp and Issleib, Susanne and Meyer-ter-Vehn, Tobias and Braun, Regine and Westekemper, Henrike and Steven, Philipp (2022) Outcomes and complications of cataract surgery in patients with chronic ocular graft-versus-host-disease-a multicenter, retrospective analysis. GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 260 (8). pp. 2613-2622. ISSN 0721-832X, 1435-702X
Full text not available from this repository. (Request a copy)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 the 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- and post-operative topical therapy. Results Seventy-three patients underwent cataract surgery in 104 eyes. In n = 84 eyes, the oGVHD NIH grade was documented; 12% (n= 12) of analyzed eyes were staged oGVHD NIH grade 1, 31% (n= 32) NIH 2 and 39% (n = 41) NIH 3. The mean BCVA improved in 82% of the eyes (n = 86 eyes). BCVA significantly increased from 0.7 +/- 0.5 to 0.4 +/- 0.4 LogMAR after surgery independent from oGVHD severity. The mean IOP decreased from 14 +/- 4 to 13 +/- 4 mmHg after surgery. Visual acuity was moderately correlated to the pre-operative degree of corneal staining (Pearson p = 0.26, p = 0.002, Cohen's effect size f= 0.29). The visual acuity decreased by 0.078 LogMar units (95% CI =0.027-0.141) with each increase of corneal staining by one grade (p = 0.05). After surgery, corneal epitheliopathy increased significantly in 42% (n = 44) of the eyes. Postoperative complications included corneal perforation (n = 6, 6%), cystoid macular edema (n = 4, 4%), and endophthalmitis (n =1 , 1%) . Conclusion Phacoemulsification in patients with chronic oGVHD significantly improves visual acuity, but is associated with an increased risk of complications in particular corneal epitheliopathy and corneal perforations.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | 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 |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Augenheilkunde |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 01 Feb 2024 07:41 |
| Last Modified: | 01 Feb 2024 07:41 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58502 |
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