Efficacy and safety of preoperative intravitreal dexamethasone implants for cataract surgery in patients with uveitis with persistent inflammation

Abstract

AbstractPurpose: This study aimed to evaluate the efficacy and safety of intravitreal dexamethasone implants for cataract surgery in patients with uveitis with frequent recurrence according to injection timing.Methods: We retrospectively reviewed medical records of patients with non‐infectious uveitis who underwent cataract surgery in Seoul St. Mary's hospital. Patients received intravitreal dexamethasone implant injections into the eyes within 3 months prior to cataract surgery. Patients were divided into two groups: patients administered intravitreal dexamethasone implant injections within 1 month (group 1) or between 1 to 3 months (group 2) prior to cataract surgery. Recurrence of uveitis, postoperative visual outcomes, and safety were reviewed. The time gap between the first uveitis recurrence and cataract surgery, anterior chamber/vitreous cell, best corrected visual acuity(BCVA), and intraocular pressure(IOP) were measured. Patients were followed up for at least 6 months after cataract surgery.Results: In total, 70 eyes of 70 patients were included in the analysis (group 1: 40, group 2: 30). Mean age was 46.60 ± 16.93 and 50.73 ± 13.42 years, respectively(p > 0.05). Groups 1 and 2 included 20(50%) and 10(33.3%) patients with uveitis‐related systemic diseases, respectively (p > 0.05). BCVA was significantly improved at postoperative day 1, week 1, and months 1 and 6 in both groups (all p < 0.05). No significant between‐group differences in BCVA were observed at any time point (p > 0.05). The recurrence of uveitis after cataract surgery was significantly earlier in group 2 than in group 1 (p = 0.04). The occurrence of cystoid macular edema was significantly lower in Group 1 (p = 0.03) Survival analysis of uveitis recurrence did not reveal a significant difference (p > 0.05).Conclusions: Intraoperative intravitreal dexamethasone implant within 3 months before cataract surgery may be considered a safe and effective option for patients with uveitis with poorly controlled inflammation.