Cataract extraction in adults with retinopathy of prematurity
T. J. Krolicki and W. Tasman
Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pa.
OBJECTIVE: To review the results of lensectomies performed to remove
visually significant cataracts in adults with regressed retinopathy of
prematurity, with special reference to postoperative vision and retinal
complications. METHODS: A chart review of consecutive cases of cataract
extraction in eyes with visually significant lens opacities and regressed
retinopathy of prematurity was conducted. RESULTS: Fourteen consecutive
eyes with retinopathy of prematurity in 10 adult patients were identified
as having undergone lensectomy to manage a visually significant cataract.
These cataract extractions were performed between June 1970 and February
1993. There were eight women and two men aged 16 to 43 years at the time of
lensectomy. A variety of lenticular opacities were noted, the most common
of which was nuclear sclerosis. Additionally, the nuclei were frequently
much harder than would be expected for the patient's age.
Phacoemulsification with implantation of a posterior chamber intraocular
lens was the most common technique for cataract extraction. Eight eyes
experienced improvement in visual acuity. However, when preoperative visual
acuity was less than 20/200, postoperative acuity of 20/60 or better was
uncommon. Six eyes were being treated for glaucoma before lensectomy.
Glaucoma control was facilitated after lensectomy in six eyes. No combined
cataract extraction and filtering procedures were performed. One eye
developed a rhegmatogenous retinal detachment 76 months after cataract
extraction. The retina was successfully reattached, but the eye suffered a
substantial decrease in visual acuity. CONCLUSION: Cataract extraction in
adult patients with retinopathy of prematurity may improve visual acuity,
facilitate examination and treatment of the posterior segment, and aid in
the management of glaucoma. The risk of retinal complications in these
patients does not appear to be excessive.
