Universität zu Köln

Gehlsen, Uta ORCID: 0000-0001-9057-9199, Faust, Christiane, Blecha, Christiane, Dietrich-Ntoukas, Tina, Eberwein, Philipp, Issleib, Susanne, Meyer-ter-Vehn, Tobias, Braun, Regine, Westekemper, Henrike and Steven, Philipp ORCID: 0000-0001-6892-3619 (2022). Outcomes and complications of cataract surgery in patients with chronic ocular graft-versus-host-disease-a multicenter, retrospective analysis. Graefes Arch. Clin. Exp. Ophthalmol., 260 (8). S. 2613 - 2623. NEW YORK: SPRINGER. ISSN 1435-702X

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Abstract

Purpose To evaluate the outcome of phacoemulsification in patients with chronic ocular Graft-versus-host disease (oGVHD) after allogeneic hematopoietic stem cell transplantation (aHSCT). Methods Retrospective, observational multicenter study from 1507 oGVHD patients. From the patient files, data were collected including best-corrected visual acuity (BCVA), intraocular pressure (IOP), Schirmer's test I, tear film break-up time (TFBUT), corneal fluorescein staining score, postoperative complications, and pre- and post-operative topical therapy. Results Seventy-three patients underwent cataract surgery in 104 eyes. In n = 84 eyes, the oGVHD NIH grade was documented; 12% (n= 12) of analyzed eyes were staged oGVHD NIH grade 1, 31% (n= 32) NIH 2 and 39% (n = 41) NIH 3. The mean BCVA improved in 82% of the eyes (n = 86 eyes). BCVA significantly increased from 0.7 +/- 0.5 to 0.4 +/- 0.4 LogMAR after surgery independent from oGVHD severity. The mean IOP decreased from 14 +/- 4 to 13 +/- 4 mmHg after surgery. Visual acuity was moderately correlated to the pre-operative degree of corneal staining (Pearson p = 0.26, p = 0.002, Cohen's effect size f= 0.29). The visual acuity decreased by 0.078 LogMar units (95% CI =0.027-0.141) with each increase of corneal staining by one grade (p = 0.05). After surgery, corneal epitheliopathy increased significantly in 42% (n = 44) of the eyes. Postoperative complications included corneal perforation (n = 6, 6%), cystoid macular edema (n = 4, 4%), and endophthalmitis (n =1 , 1%) . Conclusion Phacoemulsification in patients with chronic oGVHD significantly improves visual acuity, but is associated with an increased risk of complications in particular corneal epitheliopathy and corneal perforations.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gehlsen, Uta UNSPECIFIED orcid.org/0000-0001-9057-9199 UNSPECIFIED Faust, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Blecha, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Dietrich-Ntoukas, Tina UNSPECIFIED UNSPECIFIED UNSPECIFIED Eberwein, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Issleib, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer-ter-Vehn, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Braun, Regine UNSPECIFIED UNSPECIFIED UNSPECIFIED Westekemper, Henrike UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Philipp UNSPECIFIED orcid.org/0000-0001-6892-3619 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-691158
DOI:	10.1007/s00417-022-05613-w
Journal or Publication Title:	Graefes Arch. Clin. Exp. Ophthalmol.
Volume:	260
Number:	8
Page Range:	S. 2613 - 2623
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1435-702X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BONE-MARROW-TRANSPLANTATION; CONSENSUS DEVELOPMENT PROJECT; TOTAL-BODY IRRADIATION; QUALITY-OF-LIFE; DRY EYE; CORNEAL PERFORATION; CLINICAL-TRIALS; PHACOEMULSIFICATION; DIAGNOSIS; SEVERITY Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69115