Determining whether delayed nonarteritic ischemic optic neuropathy associated with cataract extraction is a true entity
Accepted 14 August 2006.
Purpose
To evaluate cases of delayed nonarteritic anterior and posterior ischemic optic neuropathy after cataract extraction and to evaluate the need for centralized prospective reporting of nonarteritic ischemic optic neuropathy after cataract extraction.
Setting
Neuro-ophthalmology Clinics, University of Colorado Health Sciences Center and Denver Veterans Affairs Medical Center, Denver, Colorado, USA.
Methods
A retrospective review of all patients referred to the Neuro-ophthalmology Divisions, University of Colorado Health Sciences Center and Denver Veterans Affairs Medical Center, from January 2001 to October 2005 was performed. All patients with a diagnosis of nonarteritic anterior or posterior ischemic optic neuropathy were identified. Patients with ischemic optic neuropathy that occurred between 2 months and 12 months after cataract extraction were selected for evaluation.
Results
Six eyes with nonarteritic ischemic optic neuropathy that occurred 2 to 6 months after cataract extraction in 4 patients (2 bilateral nonarteritic ischemic optic neuropathy) and 1 eye with nonarteritic ischemic optic neuropathy that occurred after 6 months in 1 patient were identified. One patient had nonarteritic ischemic optic neuropathy in 1 eye 3 months after cataract extraction and 4 years later had nonarteritic ischemic optic neuropathy in the fellow eye 5 months after cataract extraction. Follow-up after the last cataract extraction was 1 to 3 years for all patients.
Conclusions
Although an association between cataract extraction and delayed nonarteritic anterior and posterior ischemic optic neuropathy has been suggested, current data do not support a causal relationship. In addition, the window of postoperative susceptibility for delayed ischemic optic neuropathy after cataract extraction is unclear.
From the Department of Ophthalmology (Nguyen, Taravella) and Departments of Neurology and Ophthalmology (Pelak), Denver Veterans Affairs Medical Center, Rocky Mountain Lions Eye Institute, University of Colorado Health Sciences Center, Aurora, Colorado, USA
Corresponding author: Victoria S. Pelak, MD, University of Colorado Health Sciences Center. PO Box 6510, Mail Stop F727, Aurora, Colorado 80045, USA.
Presented at the ASCRS Symposium on Cataract, IOL and Refractive Surgery, San Francisco, California, USA, March 2006.
No author has a financial or proprietary interest in any material or method mentioned.
ABSTRACT