Preoperative management and cataract surgery outcomes in patients with definite ocular graft-versus-host disease diagnosed by the International Chronic Ocular Graft-Versus-Host-Disease criteria.

OBJECTIVE: To describe common preoperative treatments and visual outcomes after cataract surgery in patients with definite ocular graft-versus-host disease (oGVHD), as defined by the International Chronic Ocular Graft-Versus-Host-Disease (ICCGVHD) consensus group criteria. DESIGN: Retrospective study. PARTICIPANTS: Fifty eyes of 33 patients who had definite oGVHD, as defined by the ICCGVHD criteria, and underwent cataract extraction at Mayo Clinic were included. METHODS: Various preoperative interventions and best-corrected visual acuity preoperatively, 1 month postoperatively, and at final ophthalmology follow-up were recorded. Postoperative corneal complications were also identified. RESULTS: Fifty eyes across 33 patients (42% female) were included, with a mean age at cataract surgery of 57 ± 9 years. Common preoperative treatments used for patients included punctal occlusion via plugs or cautery (44 eyes, 88%), artificial tears (35 eyes, 70%), and autologous serum eye drops (22 eyes, 44%); topical nonsteroidal anti-inflammatory drugs were used postoperatively in 7 eyes (14%). Best-corrected visual acuity significantly improved from a preoperative mean of Snellen 20/61 (0.487 ± 0.429) to 20/26 at 1 month postoperatively (0.109 ± 0.184, P < 0.001) and remained stable at 20/29 at final ophthalmology follow-up (0.163 ± 0.381, P < 0.001). Postoperative corneal complications developed in 2 eyes (4%), including 1 corneal ulcer and 1 corneal abrasion, both of which resolved within 1 month with appropriate treatment. CONCLUSION: The ICCGVHD criteria demonstrate potential for comprehensively evaluating oGVHD before cataract surgery. In addition, patients with definite oGVHD according to these criteria are treated with a variety of interventions preoperatively and are able to achieve favorable postoperative visual outcomes with a low incidence of postoperative corneal complications.