Cataract surgery in adult patients with uveitis

Abstract

PurposeTo determine current challenges and visual results in patients with uveitis who underwent cataract surgery in 2013.MethodsWe retrospectively collected data from every consecutive uveitis patient who underwent cataract surgery during the year 2013 and studied demographic data (age, gender) along with uveitis etiology and therapeutic management. Pre and post operative anterior chamber flare was evaluated by laser flare photometry. Postoperative rate of macular edema (ME), ocular hypertension, epiretinal membrane (ERM) was also evaluated. Every patient was operated by the same surgeon (BB) and received a subconjunctival injection of dexamethasone at the end of the procedure. Use of perioperative oral prednisone was noted.ResultsTwenty eight eyes of 24 patients were operated. The mean age was 57.6, and 24 were female (85.6%). Preoperative mean best corrected visual acuity (BCVA) was 0.90 logMar. A week after surgery mean BCVA was improved to 0.26 logMar. A month later, mean BVCA was 0.26 logMar. BCVA was 0.38 logMar at 6 months and 0.27 logMar at one year. The mean preoperative flare value was 26.4 ph/ms. It increased to 42.8 ph/ms at one day and 35.0 ph/ms at one week. ME was noted postoperatively in 11 eyes (39%), of which 4 were preexistant. Four eyes (14.3%) had inflammatory glaucoma and ERM was noticed on OCT examination in 6 eyes (21.4%). Oral prednisone was used prior to surgery in 6 patients (25%) and after surgery in 10 patients (41.6%).ConclusionsCataract surgery in adult patients with uveitis has a satisfactory outcome in most of the cases. It is important to achieve a strict preoperative control of ocular inflammation. The incidence of complications such as macular edema, epiretinal membrane or glaucoma has been dramatically reduced by an appropriate management of the disease.