Efficacy and safety outcomes of cataract surgery in survivors of ebola virus disease: 12-month results from the PREVAIL VII study

Allen O. Eghrari, Jessica G. Shantha, Robin D. Ross, Collin Van Ryn, Ian Crozier, Brent Hayek, Dan Gradin, Ben Roberts, S. Grace Prakalapakorn, Fred Amegashie, Kumar Nishant, Gurcharan Singh, Robert Dolo, John Fankhauser, Bryn Burkholder, James Pettitt, Robin Gross, Tyler Brady, Bonnie Dighero-Kemp, Cavan ReillyLisa Hensley, Elizabeth Higgs, Steven Yeh, Rachel J. Bishop

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: In survivors of Ebola virus disease (EVD), intraocular viral persistence raises questions about the timing and safety of cataract surgery. To the best of our knowledge, this is the first controlled study evaluating Ebola virus persistence and cataract surgery safety and outcomes in EVDsurvivors. Methods: Seropositive EVD survivors and seronegative controls with vision worse than 20/40 from cataract and without active intraocular inflammation were enrolled. Aqueous humor from survivors was tested with reverse transcription-polymerase chain reaction for Ebola viral RNA. Participants underwent manual small-incision cataract surgery and 1 year of follow-up examinations. Results: Twenty-two eyes of 22 survivors and 12 eyes of eight controls underwent cataract surgery. All of the aqueous samples tested negative for Ebola viral RNA.Median visual acuity improved from 20/200 at baseline to 20/25 at 1 year in survivors and from count fingers to 20/50 in controls (overall, P < 0.001; between groups, P = 0.07). After a 1-month course of topical corticosteroids, 55% of survivors and 67% of controls demonstratedat least 1+anterior chamber cell. Twelve months after surgery, optical coherence tomography revealed a median increase in macular central subfield thickness of 42 µm compared with baseline (overall, P = 0.029; between groups, P = 0.995). Conclusions: EVD survivors and controls demonstrated significant visual improvement fromcataract surgery. The persistence of intraocular inflammation highlights the importance of follow-up. The absence of detectable intraocular Ebola viral RNA provides guidance regarding the safety of eye surgery in Ebola survivors. Translational Relevance: These findings demonstrate the safety and efficacy of cataract surgery in Ebola survivors and will inform ocular surgery guidelines in this population.

Original languageEnglish (US)
Article number32
Pages (from-to)1-12
Number of pages12
JournalTranslational Vision Science and Technology
Volume10
Issue number1
DOIs
StatePublished - Jan 2021

Keywords

  • Cataract surgery
  • Ebola virus disease
  • Manual small incision cataract surgery
  • Uveitis

ASJC Scopus subject areas

  • Biomedical Engineering
  • Ophthalmology

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