Purpose: Bone marrow transplantation (BMT) and pre-treatment conditioning\nincreases the risk of developing pediatric cataracts. We present the outcome\nof cataract surgery in children who have had BMT. Methods: We conducted\na retrospective chart study with 15 BMT patients (28 eyes) who underwent\ncataract extraction between 2002 and 2012. Outcome measures include\nchange in best corrected visual acuity (BCVA) and complications. Results:\n7 (47%) patients had acute lymphoid leukemia, 3 (20%) had acute myeloid\nleukemia, 2 (13%) had myelodysplastic syndrome, 1 (7%) had Fanconi\nanemia, 1 (7%) had juvenile myelomonocytic leukemia, and 1 (7%) had adrenoleukodystrophy.\nPatients received BMT at a mean age of 3.9 �± 1.6 years. 12\n(80%) patients received total body irradiation (TBI) and 3 of these 12 received\ncranial irradiation in addition to TBI; one (7%) received only cranial irradiation.\nTotal body irradiation included head and eye exposure. Mean age of cataract\nsurgery was 9.1 �± 2.3 years; mean follow-up was 55.9 �± 45.1 months. All\ncataracts were of posterior subcapsular subtype. Mean BCVA improved from\n0.7 �± 0.4 logMAR to 0.3 �± 0.5 logMAR (p < 0.001). 23/28 eyes (80%) had cataract\nextraction with intraocular lens placement; 5/28 (20%) of the eyes had\ncataract extraction with primary posterior capsulotomy and anterior vitrectomy\n(PC/AVx). 23/23 (100%) of the eyes without primary PC/AVx developed\nPCO an average of 2.3 �± 6.9 months after surgery. No eyes with primary\nPC/AVx eyes developed PCO. Conclusions: Children with history of BMT\nhave a predisposition of developing posterior subcapsular cataracts and have a\nhigh rate of visually significant PCO if the posterior capsule is left intact at the\ntime of cataract surgery.
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