visual outcome after cataract surgery in patients with retinitis pigmentosa
TRANSCRIPT
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Dr. Narayan S. AlaneDr. Mehul A. Shah
Dr. Shreya M. Shah
Visual outcome after cataract surgery in
patients with retinitis pigmentosa
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Cataract is a recognized complication of all types of
retinitis pigmentosa especially posterior sub-capsular lens
opacity which occurs at a relatively younger age, which
may be combined with a restricted visual field causing
significant visual disturbance.
Glare is a major symptom and the patient may require
surgery at a younger age.
INTRODUCTION
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Apart from the general risks of cataract surgery, there
are specific additional risk factors2 that may result in
decreased visual outcome after cataract extraction in
the presence of RP namely,
1. The zonules are usually fragile in RP.
2. Posterior capsular opacificaton and anterior capsular
contraction are more aggressive in the presence of RP.
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To study visual outcome after cataract surgery in
retinitis pigmentosa(RP) patients
To study relation of visual outcome with
-age of the patient,
-type of cataract,
-type of cataract surgery done.
PURPOSE OF THE STUDY
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We retrospectively reviewed the database in
a standard pretested format of consecutive
series of 52 eyes with RP who underwent
cataract surgery. The changes in visual
outcome were measured and data analysed
by SPSS 23.
METHODS
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The preoperative BCVA was < 6/ 60 in 94% of patients. The BCVA improved after cataract surgery from ≥6/18 in 45.2% (P < 0.001). But final BCVA did not improve in 28 eyes (53.8%).
The preoperative & final BCVA were significantly correlated; final BCVA improved in the less advanced RP group .
Results
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The final BCVA was statistically not
related to age (P<0.096), type of cataract
(P<0.691), age at which cataract surgery
done (P<0.015) or gender (P<0.317). 3.8%
patients have secondary glaucoma.
Results
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Age of the patient
No. of patients Percentage
21 to 30 3 5.8
31 to 40 12 23.1
41 to 50 15 28.8
51 to 6o 12 23.1
61 to 70 9 17.3
71 to 80 1 1.9
Total 52 100
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Vision Frequency Percentage
< 1/60 22 42.3
1/60 to 3/60 17 32.7
4/60 to 6/36 10 19.2
6/24 to 6/18 3 5.8
Total 52 100
Pre-operative vision (BCVA)
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Type of RP Frequency Percentage
Typical 50 96.2
Atypical 2 3.8
Clinical diagnosis
Glaucoma Frequency Percentage
Present 4 7.7
Abscent 48 92.3
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Vision Type of surgery
Percentage
Phaco+IOL
SICS+IOL
< 1/60 3 16 36.5
1/60 to 3/60 0 9 17.3
4/60 to 6/36 2 10 23.1
6/24 to 6/18 1 0 1.9
6/12 to 6/9 4 2 11.5
6/6 to 6/5 1 4 9.6
Total 11 41 100
Post-operative vision (BCVA)
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Final BCVA is improved in approximately half of the eyes after cataract surgery in patients with retinitis pigmentosa.
Final BCVA was better after phaco+IOL as compared to after SICS+IOL.
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Conclusion