One hundred and seventy-six patients who received a renal transplant b
etween 1982 and 1988 were examined for ocular complications of steroid
therapy. Posterior subcapsular cataracts (PSC) were present in 60 pat
ients (34.1%). Patients were classified into three groups (HS, LS, NoS
) depending on their maintenance immunosuppression therapy. The HS gro
up received high doses of steroids after renal transplantation. LS had
low steroid doses, and NoS had no steroids. The incidence of PSC was
21 of 38 in HS (55.3%), 33 of 117 in LS (28.2%), and 1 of 16 in NoS (6
.2%). The difference between HS and LS was statistically significant (
chi2 = 8.1, P<0.01) Grading the severity of PSC (PSC 0, PSC +, PSC > +) showed a significant correlation between the degree of PSC and the
steroid therapy. In the HS group. five patients had PSC +, and 16 had
PSC > ++ (76%), compared to 19 patients with PSC +, 14 patients with P
SC > ++ (42%) in the LS group (chi2 = 4.6; P<0.05). There was no corre
lation between the incidence of PSC and use of steroids for more than
three months before dialysis. Comparison with the results of our earli
er series (1973-1981)1 using high doses of steroids showed a similar i
ncidence of PSC with HS (40.7% Series 1; 55.3% Series 2) but a lower i
ncidence with LS and NoS.