Cataract development and outcome of surgery in bone marrow transplanted children.

Cataract development in bone marrow transplanted (BMT) patients was studied prospectively. There were 61 children, transplanted before the age of 18 years, who survived more than 1 year after transplantation. Patients transplanted for leukaemia (n = 43) were conditioned before BMT with cyclophosphamide (Cy) and total body irradiation (TBI). Patients with severe aplastic anaemia (SAA) (n = 9) only received Cy. None of the patients with SAA developed cataracts. All children with leukaemia, who were followed for at least 3 years (n = 37), developed lens posterior subcapsular cataracts (PSC). Cataract extraction was performed in 28 eyes, on average 5.1 years (range 3-9 years) after BMT. Postoperative corrected visual acuity was similar to that before BMT. The majority of cases needed laser capsulotomy within 2 years after cataract extraction. TBI seems to be the main cause for the high incidence of cataract after BMT. A relationship to steroid administration could not be proved, but a contributory effect is not excluded.