Abstract
BackgroundThis study sought to report the outcomes of a combined cataract extraction, intraocular lens (IOL) insertion and micro-incision vitrectomy (MIVS) procedure for the treatment of Behcet uveitis.MethodsThis investigation involved the retrospective evaluation of a case series of patients with Behcet uveitis who underwent cataract extraction, IOL insertion and MIVS in a single surgical session at the same institution between January 2013 and November 2016. Outcome measures included visual acuity, inflammatory reaction, systemic anti-inflammatory medications, intraocular pressure (IOP) and complications.ResultsSeven eyes of seven patients with a mean age of 39.00 ± 5.54 years (range, 32 to 48 years) and a mean follow-up duration of 13.57 ± 5.83 months (range, 6 to 24 months) were studied; five patients with a history of well-controlled uveitis were included. All patients underwent cataract extraction and IOL implantation combined with MIVS. All patients received postoperative steroids, which were slowly tapered during the weeks after surgery. There were no significant complications related to the surgery. Overall, best-corrected visual acuity (BCVA) was improved from log MAR (logarithm of the minimum angle of resolution) 1.67 ± 0.67 preoperatively to log MAR 0.74 ± 0.35 postoperatively; this improvement was statistically significant (p < 0.05). All eyes were deemed quiet at follow-up, and no patients required the escalation of therapy for long-term uveitis control.ConclusionsThis retrospective series indicates that a procedure that combines phacoemulsification, IOL implantation and MIVS is a feasible technique for the removal of cataracts and pathologic vitreous in eyes with Behcet uveitis. This approach can restore vision without obvious complications.
Highlights
This study sought to report the outcomes of a combined cataract extraction, intraocular lens (IOL) insertion and micro-incision vitrectomy (MIVS) procedure for the treatment of Behcet uveitis
Patients We reviewed the medical records of patients suffering from Behcet uveitis who were treated in the Department of Ophthalmology of Hebei General Hospital between January 2013 and November 2016
All patients underwent the collection of a detailed whole-body history, clinical evaluation and a comprehensive ocular examination that included the measurement of best-corrected visual acuities (BCVAs) (and conversion to the corresponding logarithm of the minimum angle of resolution values), slit-lamp examination, intraocular pressure (IOP) measurement, and fundus photography, if possible (FF 450plus; Carl Zeiss Meditec AG, Jena, Germany)
Summary
This study sought to report the outcomes of a combined cataract extraction, intraocular lens (IOL) insertion and micro-incision vitrectomy (MIVS) procedure for the treatment of Behcet uveitis. Behcet uveitis is a common condition worldwide. This condition remains problematic because of its long course and therapeutic challenges. Surgical treatment for Behcet uveitic eyes with cataract or posterior segment complications is inevitable. Fear of surgery-associated intraocular inflammation has limited the clinical application of such treatment. Combined surgery has been complicated in eyes with uveitis [5, 6]. A procedure that combines phacoemulsification and MIVS may be a feasible treatment option in cases involving patients with Behcet uveitis accompanied by cataract and posterior segment complications
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