Cataract surgery in patients with late-onset retinal degeneration

Vasileios T Papastavrou, Shyamanga Borooah, Jill M O'Brien, Neeta Ray-Chaudhuri, Baljean Dhillon, Rute Vieira, Andrew C Browning

Research output: Contribution to journalArticle

Abstract

PURPOSE: To review the outcomes in a series of patients with long anterior lens zonular fibers associated with late-onset retinal degeneration who had phacoemulsification cataract surgery.

SETTING: Newcastle Eye Centre, Newcastle upon Tyne, United Kingdom.

DESIGN: Retrospective case series.

METHODS: Inclusion criteria were patients with genetically confirmed late-onset retinal degeneration requiring cataract surgery. Perioperative data relating to surgery were collected. In addition, the corrected distance visual acuity (CDVA) and retinal imaging data were recorded. Selected lens capsules were examined using immunohistochemistry or scanning electron microscopy (SEM).

RESULTS: Eleven eyes of 7 patients were included. The long anterior lens zonular fibers made capsulorhexis challenging; however, it was completed safely in all cases. There were no intraoperative or postoperative issues with lens stability. The CDVA improved postoperatively in those cases with intact foveal photoreceptors and retinal pigment epithelium. Over the longer term, the CDVA slowly declined because of progressive atrophy of the macula. Most patients noticed a subjective improvement in vision, even those with advanced disease at baseline. Immunohistochemistry showed that the C1QTNF5 protein was expressed within the lens capsule epithelial cells, although SEM of the long anterior lens zonular fibers showed them to be smaller in diameter than normal anterior lens zonular fibers and to be composed of a helix of fibers.

CONCLUSIONS: In this small series of patients with late-onset retinal degeneration, cataract surgery was successfully performed without long-term complications involving intraocular lens stability. The objective improvement in CDVA seemed to be limited to patients with good foveal photoreceptor architecture.

Original languageEnglish
Pages (from-to)1036-1043
Number of pages8
JournalJournal of cataract and refractive surgery
Volume43
Issue number8
DOIs
Publication statusPublished - Aug 2017

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Cataract
Lenses
Visual Acuity
Electron Scanning Microscopy
Capsules
Immunohistochemistry
Capsulorhexis
Phacoemulsification
Retinal Pigment Epithelium
Intraocular Lenses
Late-Onset Retinal Degeneration
Atrophy
Epithelial Cells
Proteins

Keywords

  • Journal Article

Cite this

Papastavrou, V. T., Borooah, S., O'Brien, J. M., Ray-Chaudhuri, N., Dhillon, B., Vieira, R., & Browning, A. C. (2017). Cataract surgery in patients with late-onset retinal degeneration. Journal of cataract and refractive surgery, 43(8), 1036-1043. https://doi.org/10.1016/j.jcrs.2017.05.041

Cataract surgery in patients with late-onset retinal degeneration. / Papastavrou, Vasileios T; Borooah, Shyamanga; O'Brien, Jill M; Ray-Chaudhuri, Neeta; Dhillon, Baljean; Vieira, Rute; Browning, Andrew C.

In: Journal of cataract and refractive surgery, Vol. 43, No. 8, 08.2017, p. 1036-1043.

Research output: Contribution to journalArticle

Papastavrou, VT, Borooah, S, O'Brien, JM, Ray-Chaudhuri, N, Dhillon, B, Vieira, R & Browning, AC 2017, 'Cataract surgery in patients with late-onset retinal degeneration', Journal of cataract and refractive surgery, vol. 43, no. 8, pp. 1036-1043. https://doi.org/10.1016/j.jcrs.2017.05.041
Papastavrou, Vasileios T ; Borooah, Shyamanga ; O'Brien, Jill M ; Ray-Chaudhuri, Neeta ; Dhillon, Baljean ; Vieira, Rute ; Browning, Andrew C. / Cataract surgery in patients with late-onset retinal degeneration. In: Journal of cataract and refractive surgery. 2017 ; Vol. 43, No. 8. pp. 1036-1043.
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AU - Dhillon, Baljean

AU - Vieira, Rute

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N2 - PURPOSE: To review the outcomes in a series of patients with long anterior lens zonular fibers associated with late-onset retinal degeneration who had phacoemulsification cataract surgery.SETTING: Newcastle Eye Centre, Newcastle upon Tyne, United Kingdom.DESIGN: Retrospective case series.METHODS: Inclusion criteria were patients with genetically confirmed late-onset retinal degeneration requiring cataract surgery. Perioperative data relating to surgery were collected. In addition, the corrected distance visual acuity (CDVA) and retinal imaging data were recorded. Selected lens capsules were examined using immunohistochemistry or scanning electron microscopy (SEM).RESULTS: Eleven eyes of 7 patients were included. The long anterior lens zonular fibers made capsulorhexis challenging; however, it was completed safely in all cases. There were no intraoperative or postoperative issues with lens stability. The CDVA improved postoperatively in those cases with intact foveal photoreceptors and retinal pigment epithelium. Over the longer term, the CDVA slowly declined because of progressive atrophy of the macula. Most patients noticed a subjective improvement in vision, even those with advanced disease at baseline. Immunohistochemistry showed that the C1QTNF5 protein was expressed within the lens capsule epithelial cells, although SEM of the long anterior lens zonular fibers showed them to be smaller in diameter than normal anterior lens zonular fibers and to be composed of a helix of fibers.CONCLUSIONS: In this small series of patients with late-onset retinal degeneration, cataract surgery was successfully performed without long-term complications involving intraocular lens stability. The objective improvement in CDVA seemed to be limited to patients with good foveal photoreceptor architecture.

AB - PURPOSE: To review the outcomes in a series of patients with long anterior lens zonular fibers associated with late-onset retinal degeneration who had phacoemulsification cataract surgery.SETTING: Newcastle Eye Centre, Newcastle upon Tyne, United Kingdom.DESIGN: Retrospective case series.METHODS: Inclusion criteria were patients with genetically confirmed late-onset retinal degeneration requiring cataract surgery. Perioperative data relating to surgery were collected. In addition, the corrected distance visual acuity (CDVA) and retinal imaging data were recorded. Selected lens capsules were examined using immunohistochemistry or scanning electron microscopy (SEM).RESULTS: Eleven eyes of 7 patients were included. The long anterior lens zonular fibers made capsulorhexis challenging; however, it was completed safely in all cases. There were no intraoperative or postoperative issues with lens stability. The CDVA improved postoperatively in those cases with intact foveal photoreceptors and retinal pigment epithelium. Over the longer term, the CDVA slowly declined because of progressive atrophy of the macula. Most patients noticed a subjective improvement in vision, even those with advanced disease at baseline. Immunohistochemistry showed that the C1QTNF5 protein was expressed within the lens capsule epithelial cells, although SEM of the long anterior lens zonular fibers showed them to be smaller in diameter than normal anterior lens zonular fibers and to be composed of a helix of fibers.CONCLUSIONS: In this small series of patients with late-onset retinal degeneration, cataract surgery was successfully performed without long-term complications involving intraocular lens stability. The objective improvement in CDVA seemed to be limited to patients with good foveal photoreceptor architecture.

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