CATARACT-EXTRACTION IN ADULTS WITH RETINOPATHY OF PREMATURITY

Objective: To review the results of lensectomies performed to remove v isually significant cataracts in adults with regressed retinopathy of prematurity, with special reference to postoperative vision and retina l complications. Methods: A chart review of consecutive cases of catar act extraction in eyes with visually significant lens opacities and re gressed retinopathy of prematurity was conducted. Results: Fourteen co nsecutive eyes with retinopathy of prematurity in 10 adult: patients w ere identified as having undergone lensectomy to manage a visually sig nificant cataract. These cataract extractions were performed between J une 1970 and February 1993. There were eight women and two men aged 16 to 43 years at the time of lensectomy. A variety of lenticular opacit ies were noted, the most common of which was nuclear sclerosis. Additi onally, the nuclei were frequently much harder than would be expected for the patient's age. Phacoemulsification with implantation of a post erior chamber intraocular lens was the most common technique for catar act extraction. Eight eyes experienced improvement in visual acuity. H owever, when preoperative visual acuity was less than 20/200, postoper ative acuity of 20/60 or better was uncommon. Six eyes were being trea ted for glaucoma before lensectomy. Glaucoma control was facilitated a fter lensectomy in six eyes. No combined cataract extraction and filte ring procedures were performed. One eye developed a rhegmatogenous ret inal detachment 76 months after cataract extraction. The retina was su ccessfully reattached, but the eye suffered a substantial decrease in visual acuity. Conclusion: Cataract extraction in adult patients with retinopathy of prematurity may improve visual acuity, facilitate exami nation and treatment of the posterior segment, and aid in the manageme nt of glaucoma. The risk of retinal complications in these patients do es not appear to be excessive.