Cataract in retinitis pigmentosa An analysis of cataract surgery results and pathological lens changes

Abstract

The result of cataract surgery and lens pathoanatomical examination were presented in patients with retinitis pigmentosa (RP). A retrospective study of 24 cataract extractions in 15 RP patients was carried out, with special regard to visual outcome and surgical complications. The results were compared to an age matched randomly selected control group. In the retinitis pigmentosa group the post-operative visual acuity was generally good, and the surgical complications except for one case of central venous thrombosis were not more frequent than in the control group. Seven lenses from 5 patients with RP were analysed using transmission electron microscopy and quantitative microradiography. In the lenses with a progressive subcapsular edema, extensive extracellular vacuolization was found in the lens epithelium. Focal degeneration of epithelial cells was seen both in the more stationary posterior subcapsular cataracts and the progressive subcapsular cataracts. Different degrees of mitochondrial swelling was found in the epithelial cells of the stationary cataracts. The subcapsular lens fiber changes consisted of an extensive swelling of hydrated cells together with a significant reduction in their dry mass content. Migrating elongated nuclei-containing cells were found on the posterior capsule in both stationary and progressive cataracts.

Anterior lens epithelium in cataract patients with retinitis pigmentosa – scanning and transmission electron microscopy study

“…Much less is known about the structure of the lens epithelium in patients with RP. In the study where the lenses from patients with RP with a progressive subcapsular cataract were analysed using TEM and quantitative microradiography (Fagerholm & Philipson ), extensive extracellular vacuolization was found in the lens epithelium. Focal degeneration of epithelial cells was seen in both the more stationary posterior subcapsular cataracts and the progressive subcapsular cataracts.…”

Outcomes following cataract surgery in choroideremia

“…11,12 A retrospective analysis of 142 eyes of 89 patients with retinitis pigmentosa 13 reported a 14% rate of post-operative CMO as detected by fluorescein angiography. This compared with rates detected by SD-OCT in normal eyes after cataract surgery of between 4 and 11%.…”