title: Long-term outcome of cataract surgery in patients with idiopathic hypoparathyroidism and its relationship with their calcemic status.
abstract: Cataract is a cardinal manifestation of hypoparathyroidism. Although patients with hypoparathyroidism require cataract surgery at a younger age than individuals without hypoparathyroidism, there is limited information on the outcome of this surgery. We assessed long-term complications of cataract surgery in patients with idiopathic hypoparathyroidism (IH) and its relationship with their clinical and biochemical parameters. Twenty-seven patients with IH and 25 nonhypoparathyroid controls with a minimum follow-up of 2 years after cataract surgery were assessed for visual acuity, intraocular pressure, lens centricity, Nd:YAG laser capsulotomy, and the severity of posterior capsular opacification (PCO) and anterior capsular opacification. High-resolution optical slit-lamp images were analyzed by an ophthalmologist. Patients with IH had cataract surgery at a younger age than controls (34.0 ± 16.4 years vs 58.0 ± 11.2 years, P < 0.001). A higher proportion of IH patients had dense white PCO (75.0 % vs 39.4 %, P = 0.004), Nd:YAG laser capsulotomy (44.2 % vs 10.0 %, P = 0.001), anterior capsular opacification (97.7 % vs 84.2 %, P = 0.03), and a decentric lens (28.3% vs 2.6 %, P = 0.001) at a comparable time after surgery (8.6 ± 6.1 years vs 8.7 ± 6.8 years, P = 0.85). On regression analysis, the severity of PCO in IH correlated only with male sex and not with other factors, including serum total calcium and inorganic phosphorus levels at the baseline and during follow-up. To conclude, patients with IH are likelier than individuals without IH to develop PCO and to require Nd:YAG laser capsulotomy after cataract surgery. Proper precautions should be taken during surgery to minimize this complication in IH.
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Soma
authors.initials: S
authors.lastname: Saha
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Shiva Prasad
authors.initials: SP
authors.lastname: Gantyala
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Sameer
authors.initials: S
authors.lastname: Aggarwal
authors.affiliation: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Vishnubhatla
authors.initials: V
authors.lastname: Sreenivas
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India. radhika_tan@yahoo.com.
authors.forename: Radhika
authors.initials: R
authors.lastname: Tandon
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, 110029, India. gosravinder@hotmail.com.
authors.forename: Ravinder
authors.initials: R
authors.lastname: Goswami
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002386:Cataract / Q000150:complications / Q000473:pathology; D002387:Cataract Extraction / Q000009:adverse effects; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000150:complications*; D007011:Hypoparathyroidism / Q000150:complications*; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000601:surgery; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology; D012044:Regression Analysis; D066167:Slit Lamp; D013997:Time Factors; D016896:Treatment Outcome
keywords: Calcium; Cataract; Complications; Hypoparathyroidism