Long-term Outcomes of Cataract Surgery in Patients with Retinitis Pigmentosa

Purpose: To investigate the long-term outcomes of cataract surgery in patients with retinitis pigmentosa (RP). Design: Retrospective, observational study. Participants: Sixty-four patients with typical RP (22 men, 42 women; average age, 62.8 +/- 10.1 years) who underwent cataract surgery at Kyushu University Hospital between May 2007 and October 2015 and were followed up for >= 3 years after the surgery. Methods: Differences between presurgery and postsurgery visual function, including best-corrected visual acuity (BCVA) and parameters in the Humphrey field analyzer (HFA) examination using the central 10-2 program, were investigated. The presurgery conditions of the foveal ellipsoid zone (EZ) were classified into 3 grades (grade 1: invisible; grade 2: abnormal; grade 3: normal) based on OCT findings. Main Outcome Measures: BCVA, the retinal sensitivity in the HFA 10-2 test. Results: Cataract surgery was performed in 96 eyes, with an average follow-up period of 5.8 +/- 2.4 years. The mean presurgery BCVA was 0.64 +/- 0.52 logarithm of the minimum angle of resolution (logMAR), and the final postsurgery BCVA was 0.61 +/- 0.67 logMAR (P = 0.57). Significant improvement in the postsurgery BCVA was observed only in eyes with preserved foveal EZ (grade 3) (P < 0.01). In 62 eyes of 45 patients who underwent the HFA 10-2 test, the mean values of deviation, macular sensitivity, and foveal sensitivity at the final visit were significantly decreased compared with preoperative values (P < 0.01), whereas those in grade 3 eyes did not change significantly after the surgery (P = 0.13). Conclusions: In the long-term course after cataract surgery in patients with RP, many patients experienced vision loss with progression of the disease. The preoperative finding of preserved foveal EZ was associated with a better visual prognosis, suggesting that EZ evaluation is useful for predicting the long-term visual outcome of cataract surgery in patients with RP. (C) 2021 by the American Academy of Ophthalmology

Automated summary

This study investigated the long-term outcomes of cataract surgery in patients with retinitis pigmentosa (RP). Many patients experienced vision loss after the surgery. The preoperative finding of preserved foveal ellipsoid zone (EZ) was associated with a better visual prognosis.