Outcome of cataract surgery in patients with retinitis pigmentosa

Aim - To determine the visual benefit of cataract extraction in patients wi th retinitis pigmentosa and to identify risk factors for poor outcome. Methods - A retrospective analysis was undertaken of a continuous series of 142 eyes of 89 patients with retinitis pigmentosa undergoing cataract surg ery between 1985 and 1997. Results - Mean age at surgery was 47.5 years (range 24-81 years). In 100 ey es there was posterior subcapsular lens opacity alone, 37 eyes also had mod erate nuclear sclerosis, and five had only nuclear sclerosis. All patients had central visual fields of < 10 degrees. Overall, mean visual acuity impr oved from 1.05 (SD 0.38) preoperatively to 0.63 (SD 0.49) postoperatively o n the logMAR scale. Significant postoperative capsular opacification occurr ed in 88/139 eyes (63%) and 45.1% required capsulotomy. Anterior capsulotom y was undertaken in 5/52 (9.6%) eyes undergoing phacoemulsification. Postop erative macular oedema was noted in 20 (14%) eyes. Visual acuity improved i n 109 eyes (77%), was unchanged in 29 eyes (20.5%), and worsened after surg ery in four eyes (2.5%). 86/89 patients reported major improvement of visua l function. Conclusions - Cataract surgery for relatively minor lens opacities is benef icial in patients with retinitis pigmentosa, and most report subjective imp rovement of visual symptoms. The incidence of capsular opacification is hig h and anterior capsular contraction may occur. The number of eyes with poor vision due to macular oedema was unexpectedly low.