Visual outcomes of cataractous eyes with retinitis pigmentosa following cataract surgery

Objective

To evaluate the visual outcomes of cataract surgery in patients with retinitis pigmentosa (RP).

Methods

A serial case-observational study was conducted.One hundred and eleven eyes of 67 patients with RP and cataract who received phacoemulsification with posterior chamber intraocular lens implantation in Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong from January 2011 to December 2015 were included.Best corrected visual acuity (BCVA) was examined using standard visual chart before and after surgery and converted to logarithm of the minimal angle of resolution (LogMAR) units.Optical coherence tomography was employed to examine the retinas in 19 eyes before surgery and the eyes were graded into gradeⅠ, Ⅱ and Ⅲ according to the integrity of inner segment ellipsoid zone (ISe).The correlation between the grading of ISe and postoperative BCVA was analyzed.This study complied with the Declaration of Helsinki, and study protocol was approved by an Ethics Committee of Joint Shantou International Eye Center (No.EC20170310(2)-P03).Written informed consent was obtained from each patient before operation.

Results

The vision was improved in 82 eyes (73.9%) and not obviously changed in 29 eyes (26.1%) after surgery.The median BCVA was improved from preoperative 0.82 (0.60, 1.40) LogMAR to postoperative 0.40 (0.22, 0.70) LogMAR, showing a significant difference between pre-operation and post-operation (Z=-8.76, P<0.01).The proportion of eyes with BCVA more than 0.52 LogMAR was significantly reduced from preoperative 79.3% (88/111) to postoperative 38.7% (43/111), and the proportion of eyes with BCVA more than 1.3 LogMAR was significantly reduced from preoperative 28.8% (32/111) to postoperative 4.5% (5/111) (χ²=37.711, 23.643; both at P<0.01).A positive correlation was found between the grading of ISe integrity and postoperative BCVA(r_S=0.959, P<0.01).

Conclusions

Phacoemulsification with posterior chamber IOL implantation can improve the BCVA of RP patients.The integrity of the ISe can predict the postoperative BCVA in RP patients with cataract.

Retinitis pigmentosa; Cataract; Surgery; Optical coherence tomography