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Ocular complications in patients with lung transplants
  1. Ahmad B Tarabishy1,
  2. Omar F Khatib2,
  3. John R Nocero3,
  4. Marie Budev4,
  5. Peter K Kaiser1
  1. 1Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
  2. 2Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA
  3. 3Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
  4. 4Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
  1. Correspondence to Dr Peter K Kaiser, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk i32, Cleveland, OH 44195, USA; pkkaiser{at}


Aim To describe infectious and non-infectious ocular complications found in patients with lung transplants.

Methods 545 patients underwent lung transplantation from January 1998 to September 2008 at the Cleveland Clinic. Patients who underwent ophthalmic examination at the Cole Eye Institute after lung transplantation were included in the study.

Outcomes Diagnoses, treatments, surgeries, laboratory parameters of immune status and patient survival were examined.

Results Of the 545 patients who received a lung transplant during the study period at the Cleveland Clinic, 46 (8.4%) patients underwent ophthalmology examination after a lung transplant. The most common ocular finding was posterior subcapsular cataract, found in 13/46 (28.3%) patients. Infectious ocular complications were present in 6/46 patients (13.0%) including fungal infections (rhino-orbital mucormycosis (n=1), disseminated Pseudallescheria boydii infection (n=2)), cytomegalovirus retinitis (n=1), varicella-zoster virus keratouveitis (n=1) and herpes zoster ophthalmicus (n=1). Five of six patients with infectious ocular complications died within 6 months of evaluation. Decreased absolute lymphocyte count was associated with infectious ocular complications (p=0.014).

Conclusions Many ocular conditions can occur in patients with lung transplants. Ocular infectious complications were uncommon but may be associated with increased mortality.

  • Lung transplantation
  • immunosuppression
  • posterior subcapsular cataract
  • Pseudallescheria boydii
  • rhizopus mucor
  • cytomegalovirus
  • varicella-zoster virus
  • microbiology
  • immunology
  • infection

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  • Funding This study was supported by an unrestricted grant from Research to Prevent Blindness.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Cleveland Clinic IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.