Continuous oral versus single pulse intravenous corticosteroid in the prevention of inflammation following cataract surgery in uveitis patients

Abstract

Abstract Purpose To compare post‐operative inflammation and development of cystoid macular oedema (CMO) in uveitis patients undergoing cataract surgery and intraocular lens (IOL) implantation who had either pre‐operative oral or intra‐venous (IV) corticosteroid. Methods Retrospective case note study comparing uveitis patients undergoing phakoemulsification cataract surgery and implantation of an acrylic IOL (performed by one surgeon), having either oral corticosteroid (usually 40mg prednisolone two weeks prior to surgery and tapered by 5‐10mg weekly post‐operatively) or a single 500mg IV methylprednisolone pulse one hour prior to surgery. Results 30 procedures (35 patients) were identified where pre‐operative oral corticosteroid had been given, and 93 procedures (76 patients) where IV corticosteroid was given. In the oral corticosteroid cohort there were 2 (7%) episodes of fibrinous uveitis and 4 (13%) episodes of CMO within 90 days of the surgery. In the IV cohort there were 3 (3%) episodes of fibrinous uveitis and 16 (17%) episodes of CMO within 90 days of surgery. There was no statistically significant difference in the number of episodes of fibrinous uveitis or CMO between the two groups. Conclusion There was no difference in the incidence of post‐operative fibrinous uveitis or CMO in patients who were given either pre‐operative oral or IV corticosteroid. A single pulse of 500mg IV methylprednisolone appears a reasonable alternative to a course of oral prednisolone in uveitis patients undergoing cataract surgery.