Key Takeaways

  • Cataract continues to be a major cause of blindness, but surgical outcomes have improved, especially for simple cataracts.
  • More complex cases with ocular surface disease like Stevens–Johnson syndrome are especially challenging for cataract surgery.
  • The conditions can influence corneal scarring and inflammation and thus complicate surgery.
  • Ocular surface reconstruction along with the use of immunosuppressants can stabilize them preoperatively.
  • Proper planning and staged procedure can result in successful cataract surgery and better vision in complicated cases.

Purpose of review

Cataracts are a significant cause of blindness and visual impairment worldwide. With the recent advances in cataract surgery techniques, outcomes have improved significantly in uncomplicated cases. This article discusses the challenges and outcomes of cataract surgery in complex cases targeting eyes with ocular surface diseases like Stevens–Johnson syndrome, ocular cicatricial pemphigoid, Mooren’s ulcer, vernal keratoconjunctivitis and limbal stem cell deficiency.

 

Recent findings

Ocular surface diseases are commonly associated with corneal scarring and vascularization, conjunctival inflammation, symblepharon and forniceal shortening. Any surgical intervention in a hostile ocular surface environment may worsen the disease, which may result in visual deterioration. In recent past, with the use of immunosuppressants and with the introduction of different ocular surface reconstruction surgeries; stabilization of ocular surface can be achieved prior to planning cataract surgery. This kind of step-wise approach can considerably improve visual outcomes in such cases.

 

Summary

Cataract surgery in ocular surface diseases needs careful preoperative, intraoperative and postoperative planning. Performed in a staged manner under favorable ocular environment, it has good visual outcomes and can improve the quality of life in such patients.