Aims To study the relationship between the retinal microstructures and the best-corrected visual acuity (BCVA) after cataract surgery in patients with retinitis pigmentosa (RP).

Methods 58 eyes of 43 consecutive RP patients who underwent cataract surgery were studied. The BCVA was measured before and 3 months after the surgery. The appearance of the inner segment/outer segment (IS/OS) line of the photoreceptors in the optical coherence tomographic (OCT) images at the fovea was graded; Grade 1, IS/OS line not visible; Grade 2, IS/OS line abnormal or discontinuous; and Grade 3, IS/OS line normal. The central foveal thickness (CFT) and the length of the IS/OS line were measured in the spectral-domain OCT images.

Results The postoperative BCVAs in logMAR units (Grade 1, 1.04±0.36; Grade 2, 0.33±0.16; Grade 3, 0.08±0.14) and the improvements in the BCVA in logMAR units (Grade 1, 0.22±0.28; Grade 2, 0.53±0.48; Grade 3, 0.54±0.35) were significantly different among Grade 1, 2 and 3 groups (p<0.0001, p=0.0378; respectively). A postoperative BCVA of <0.2 logMAR units was achieved in 0% in Grade 1, 20% in Grade 2 and 74% in Grade 3 (p<0.0001). There was a significant correlation between the postoperative BCVA and the length of the IS/OS line (r=−0.601 p<0.0001) or the CFT (r=−0.510, p<0.0001).

Conclusions The presence of normal IS/OS line in the OCT images is associated with good visual recovery after cataract surgery in RP patients. The integrity of the IS/OS line may be important for predicting good postoperative BCVA.