Incidence and Outcomes of Cataract in Eyes with Ocular Cicatricial Pemphigoid

Pichaporn Artornsombudh, Department of Ophthalmology, Somdech Phra Pinklao Hospital, Royal Thai Navy, Bangkok, Thailand.
Maxwell Pistilli, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Craig W. Newcomb, Biostatistical Analysis Center, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
C Stephen Foster, Department of Ophthalmology, Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.
Douglas A. Jabs, Wilmer Eye Institute, Department of Ophthalmology, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Jennifer E. Thorne, Wilmer Eye Institute, Department of Ophthalmology, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Nirali P. Bhatt, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
James T. Rosenbaum, Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA.
Grace A. Levy-Clarke, Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia, USA.
H Nida Sen, Department od Ophthalmology, George Washington University, Washington, District of Columbia, USA.
Eric B. Suhler, Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA.
Kurt A. Dreger, Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Jeanine M. Buchanich, Center for Occupational Biostatistics and Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.
Hosne Begum, Wilmer Eye Institute, Department of Ophthalmology, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Tonetta D. Fitzgerald, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Naira Khachatryan, Department of Ophthalmology, Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.
Teresa L. Liesegang, Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA.
Gui-Shuang Ying, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Sapna S. Gangaputra, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
John H. Kempen, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
Site Cohort Study Research Group, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.

Document Type

Journal Article

Publication Date

2-5-2025

Journal

Ocular immunology and inflammation

DOI

10.1080/09273948.2025.2450471

Keywords

Age-related cataract surgery; incidence of cataract; ocular cicatricial pemphigoid; outcome of cataract surgery; visual improvement

Abstract

PURPOSE: To identify the incidence of cataract and the outcomes of cataract surgery in eyes with ocular cicatricial pemphigoid (OCP). METHODS: Phakic eyes were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study and followed for the incidence of visually significant cataract defined as: newly reduced visual acuity 20/50 or worse attributed to cataract; and/or incident cataract surgery. Secondarily, all eyes with OCP that underwent cataract surgery and had a year of follow up thereafter, were included in an analysis of visual outcome. RESULTS: Three hundred fifty-five phakic eyes (200 patients) with OCP were at risk. Eighty eyes developed visually significant cataract over 1064 eye years (incidence rate = 7.5%/eye-year, 95% confidence interval [CI] = 5.6 to 10.1). Higher age was associated with increased incidence of cataract (adjusted hazard ratio [aHR] = 4.47; 95% CI, 1.95-10.23 for age 60-75 inclusive and aHR = 8.37; 95% CI, 3.60-19.42 for age > 75, each compared with age <60 years). Seventy-nine eyes of 61 patients were monitored for > = 1 year following cataract surgery. Cataract surgery was associated with an improvement of vision around 4 lines, which was sustained through at least 48 months. Poorer pre-operative visual acuity was associated with poorer long-term visual outcome. CONCLUSIONS: The incidence of cataract was high in this older population. No factors predictive of cataract such as duration of OCP or use of corticosteroids were identified. Visual acuity improved after surgery by a median of 4 lines' gain at one year; poorer long-term outcome among those with initially poorer visual acuity may be secondary to corneal scarring.

Department

Ophthalmology

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