After cataract surgery, many patients with retinitis pigmentosa (RP) experience vision loss as the disease progresses, according to study findings published in Ophthalmology Retina. The study also indicates that preserved foveal ellipsoid zone (EZ) before surgery is associated with a better visual prognosis. The researchers note that preoperative EZ status at the fovea would be helpful for predicting long-term visual outcomes in patients with RP following cataract surgery.
A total of 96 eyes of 64 patients with typical RP (average age: 62.8±10.1 years, 22 men, 42 women) were included in the study. All patients underwent cataract surgery at Kyushu University Hospital between May 2007 and October 2015.
Investigators used central 10-2 fields to explore differences between pre- and post-surgery visual function, including best-corrected visual acuity (BCVA) and parameters in the Humphrey Field Analyzer (HFA) examinations. They categorized the preoperative conditions of the foveal EZ into 3 grades (grade 1: invisible, grade 2: abnormal, grade: 3 normal) based on optical coherence tomography results. The average follow-up period was 5.8±2.4 years.
According to investigators, the mean preoperative BCVA was 0.64±0.52 logMAR, and the final postoperative BCVA was 0.61±0.67 logMAR (P =.57). The analysis shows that only grade 3 eyes experienced a significant improvement in postoperative BCVA (P <.01).
At the final visit, the mean values of deviation, macular sensitivity and foveal sensitivity were significantly reduced in 62 eyes of 45 patients who received HFA 10-2 tests, while the grade 3 eyes showed no reduction in any parameters.
After cataract surgery, no severe complications such as suprachoroidal hemorrhage or lens nucleus drop during the operation were reported.
A limitation of the study is the possibility of unknown confounding factors.
“Our present findings also suggest that cataract surgery may restore visual function for a long period in RP patients who have a preserved EZ and/or less-advanced RP,” the study explains. “However, in patients with advanced RP, cataract surgery may not be effective at achieving long-term visual recovery.”
Nakamura S, Fujiwara K, Yoshida N, et al. Long-term outcomes of cataract surgery in patients with retinitis pigmentosa. Ophthalmol Retina. Published online December 16, 2021. doi:10.1016/j.oret.2021.12.010