Discussion
RP is a common hereditary eye disease and most RP patients are
complicated with cataract. The lens opacification often occurs in the
central of posterior capsule or posterior polar
cortex3, which seriously affects the residual tubular
vision. For patients with RP complicated with cataract, current studies
have proved that most patients have improved visual acuity and visual
field after surgery4, and the effect is clear.
Cataract surgery itself is safe and reliable, and does not lead to the
occurrence and progress of other RP related complications. Therefore, it
is suggested that RP complicated with cataract should be treated by
surgery5-7. The results of this study also showed that
most of the patients’ vision was improved, the operation effect was
good, and the operation was safe and reliable.
Most studies have reported that the final postoperative vision of
patients is closely related to the structure of macular
area8, 9. In this study, it was also found that the
visual acuity of patients with relatively healthy macular before surgery
was significantly improved, while the visual acuity of patients with
significantly thinner macular was limited. This also suggests that for
RP patients with cataract, preoperative OCT examination is very
important for predicting postoperative vision10.
Due to the common lens suspensory ligament relaxation in RP patients
with cataract, it is necessary to pay attention to the prevention and
treatment of capsule tear, suspensory ligament rupture and other related
intraoperative complications. The capsule contraction of such patients
is relatively rapid after surgery. The suspensory ligament relaxation is
easy to cause CCS and dislocation of the IOL11. In
this study, four cases of CCS occurred, and were treated with capsule
loosening operation at six months after the cataract surgery. The
patients were not implanted with CTR. And there was no CCS among CTR
implanted patients. Bayyoud T etc12. reported that
there were 52 eyes of RP with cataract surgery patients. Two cases of
CCS happened in no implanted CTR group, while there no CCS occured in
implanted CTR group after a median follow-up of 26 months. The incidence
was 4%. It also suggested that CTR implantation can help to reduce the
postoperative CCS in RP with cataract surgery. In addition, patients
with RP complicated with cataract are relatively young in age, and
posterior capsular opacity (PCO) occurs quickly, which requires timely
treatment. CTR implantation also has certain effects on the prevention
of PCO12.
Our results showed that IOP was higher and corneal ECC was less after
surgery. Though they were in normal range, but it reminded us to pay
attention to the IOP and ECC in RP with cataract surgery.There were some
reports that the postoperative macular edema may occur in RP with
cataract surgery5, 12. But there was not found in this
study. The occurrence of postoperative macular edema of cataract surgery
associated with many factors. Because of the RP patients themselves
severe retinopathy, macular edema would further damage eyesight. So you
need to pay special attention to that postoperative oct examination
should be carried out regularly .