Cataract surgery in eyes with retinitis pigmentosa is safe with heightened risk of cystoid macular edema

Cataract surgery can be safe and effective for individuals with cataractous eyes affected by retinitis pigmentosa (RP), according to a poster presented at AAO 2023. However, the study highlights a higher risk of developing postoperative cystoid macular edema (CME) in eyes with RP compared to those without ocular comorbidities.

Among the 114,359 eyes included in this retrospective study, 64 were diagnosed with retinitis pigmentosa. Notably, individuals with RP were, on average, 57 years old, while controls without ocular comorbidities had an average age of 75. The study also found that females constituted 44% of the RP group, compared to 60% in the control group.

The preoperative and postoperative visual acuity (VA) outcomes in eyes with RP were less favorable than in controls. The mean preoperative VA was 1.02 for eyes with RP compared to 0.59 for controls. Postoperative VA results revealed a similar trend, with eyes with RP scoring 0.83 versus 0.14 in controls (P < 0.001). The mean VA gain in eyes with RP was 0.18 ± 0.58, significantly lower than the 0.43 ± 0.48 observed in controls (P < 0.001).

Despite comparable rates of intraoperative complications such as pupil size, posterior capsular tears, and zonular dialysis between the groups, the study found a noteworthy discrepancy in the occurrence of postoperative CME. A substantial 7.8% of eyes with RP experienced CME, a significantly higher rate than the 1% observed in controls (P < 0.001). The incidence of intraocular lens subluxation was found to be similar in both groups.

Reference
Shakarchi A, et al. Cataract Surgery in Eyes With Retinitis Pigmentosa. Presented at: AAO 2023.