Long-term outcome of cataract surgery in patients with idiopathic hypoparathyroidism and its relationship with their calcemic status

Abstract

Cataract is a cardinal manifestation of hypoparathyroidism. Although patients with hypoparathyroidism require cataract surgery at a younger age than individuals without hypoparathyroidism, there is limited information on the outcome of this surgery. We assessed long-term complications of cataract surgery in patients with idiopathic hypoparathyroidism (IH) and its relationship with their clinical and biochemical parameters. Twenty-seven patients with IH and 25 nonhypoparathyroid controls with a minimum follow-up of 2 years after cataract surgery were assessed for visual acuity, intraocular pressure, lens centricity, Nd:YAG laser capsulotomy, and the severity of posterior capsular opacification (PCO) and anterior capsular opacification. High-resolution optical slit-lamp images were analyzed by an ophthalmologist. Patients with IH had cataract surgery at a younger age than controls (34.0 ± 16.4 years vs 58.0 ± 11.2 years, P < 0.001). A higher proportion of IH patients had dense white PCO (75.0 % vs 39.4 %, P = 0.004), Nd:YAG laser capsulotomy (44.2 % vs 10.0 %, P = 0.001), anterior capsular opacification (97.7 % vs 84.2 %, P = 0.03), and a decentric lens (28.3% vs 2.6 %, P = 0.001) at a comparable time after surgery (8.6 ± 6.1 years vs 8.7 ± 6.8 years, P = 0.85). On regression analysis, the severity of PCO in IH correlated only with male sex and not with other factors, including serum total calcium and inorganic phosphorus levels at the baseline and during follow-up. To conclude, patients with IH are likelier than individuals without IH to develop PCO and to require Nd:YAG laser capsulotomy after cataract surgery. Proper precautions should be taken during surgery to minimize this complication in IH.

Clinical and genetic characteristics of Pseudohypoparathyroidism in the Chinese population

“…The results of the present study include descriptions of the prevalence of chronic complications in the Asian PHP population. Cataracts and intracranial calcification are common chronic complications of hypoparathyroidism and have been observed in 75%‐97.7% and 60%‐70%, respectively, of idiopathic hypoparathyroidism patients. These complications are related to duration of disease and Ca/P ratio .…”

Clinical presentation and management of hypoparathyroidism

“…Cataract is a typical manifestation of hypoparathyroidism. In a caseecontrol study, the patients with idiopathic hypoparathyroidism and cataracts, were significantly younger than patients with cataracts without hypoparathyroidism and had evidence of more-severe posterior capsule disease and a higher rate of anterior capsule disease [57]. In the Danish caseecontrol investigations, patients affected by non-surgical hypoparathyroidism had an increased hazard ratio of 4.21 (95% CI: 2.13e8.34) compared with controls, but the risk of cataracts in patients with post-surgical hypoparathyroidism was not significantly different compared to the general population.…”

Review of clinical practice guidelines for hypoparathyroidism

“…• Пациентам с гипопаратиреозом рекомендуется периодический осмотр врача-офтальмолога для своевременной диагностики осложнений со стороны глаз [27,29,36,47,63,64]. УУР С (УДД 5)…”