title: Outcomes of phacoemulsification in patients with chronic ocular graft-versus-host disease.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the outcomes of phacoemulsification in patients with ocular graft-versus-host disease (GVHD).
  
  
  METHODS
  The occurrence of cataracts, cataract surgery, and its outcomes were analyzed in the medical records of 229 patients (458 eyes) with ocular GVHD. Outcome measures included pre- and postoperative corrected distance visual acuity (CDVA) and the rate of postoperative complications.
  
  
  RESULTS
  Of the 458 eyes evaluated, 58 were pseudophakic; from the 400 phakic eyes, 238 (59 %) presented with cataracts and 62 (26 %) underwent cataract surgery. Analysis of postoperative complications and visual outcomes at 1 month was performed in 51 eyes in which detailed surgical and immediate postoperative records were available. Preoperatively, the mean CDVA was 0.67 ± 0.57 LogMAR (Snellen 20/93), improving postoperatively to 0.17 ± 0.18 (Snellen 20/29) at 1 month (P < 0.0001), and to 0.13 ± 0.14 (Snellen 20/26) by the final follow-up visit (P < 0.0001). Postoperative complications included corneal epithelial defects (8 %), filamentary keratitis (6 %), worsening of corneal epitheliopathy (16 %), posterior capsular opacification (18 %), and cystoid macular edema (4 %). A corrected distance visual acuity of 20/30 or better was achieved in 87 % of the eyes; suboptimal CDVA improvement was attributable to severe ocular surface disease, pre-existing advanced glaucoma, and prior macular surgery.
  
  
  CONCLUSIONS
  Phacoemulsification in patients with chronic ocular GVHD is a safe and efficacious procedure resulting in significant visual improvement. Overall, postoperative adverse events responded well to timely management.
authors.affiliation: Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Cornea Service, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.
authors.forename: Ujwala S
authors.initials: US
authors.lastname: Saboo
authors.forename: Francisco
authors.initials: F
authors.lastname: Amparo
authors.forename: Hasanain
authors.initials: H
authors.lastname: Shikari
authors.forename: Ula V
authors.initials: UV
authors.lastname: Jurkunas
authors.forename: Reza
authors.initials: R
authors.lastname: Dana
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000150:complications*; D005128:Eye Diseases / Q000150:complications*; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D019654:Lens Implantation, Intraocular; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D019591:Pseudophakia / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult