Abstract
BackgroundThe purpose of this study was to evaluate patients with persistent iritis after cataract surgery to determine its incidence and risk factors. Adjusting the management of patients at risk could allow for a more predictable post-operative course and outcome. A retrospective chart review was performed of patients who had post-operative iritis longer than 1 month after cataract surgery during a 2-year period at Storm Eye Institute at the Medical University of South Carolina (MUSC) in Charleston, South Carolina. Patient demographics and various pre-operative, intra-operative, and post-operative factors were analyzed for trends.ResultsThirty-nine patients (49 eyes) met the inclusion criteria, and this group was compared to a control cohort of 40 patients (66 eyes) who did not have persistent iritis after cataract surgery. The overall incidence of post-operative iritis was 1.75%. In all patients with post-operative iritis lasting greater than 1 month, African American race and pupil expansion device use were statistically significant factors. After excluding patients with a history of ocular inflammation or known inflammatory or autoimmune diagnosis (1.20% incidence), there were still a significantly higher proportion of African Americans compared to the control group. When patients with post-operative iritis of less than 6 months in duration were additionally excluded, the incidence was 0.32%, and history of diabetes was statistically significant in addition to race.ConclusionsRisk factors for persistent iritis after cataract surgery include being diabetic, of African American racial background, and pupil expansion device use. These patients can be better informed of the higher risk of prolonged inflammation in their post-operative course, and peri-operative management can be tailored accordingly.
Highlights
The purpose of this study was to evaluate patients with persistent iritis after cataract surgery to determine its incidence and risk factors
To determine the incidence of persistent post-operative iritis, another SPARC data query produced the number of total procedures performed in the 2-year time period that were billed with a Current Procedural Terminology (CPT) code of 66982 or 66984
Two patients (2 eyes) were noted to have poor compliance. This is the first report of risk factors associated with prolonged post-operative iritis in patients who underwent uncomplicated cataract surgery by phacoemulsification and who did not have a history of uveitis or other underlying inflammatory disorders
Summary
The purpose of this study was to evaluate patients with persistent iritis after cataract surgery to determine its incidence and risk factors. A retrospective chart review was performed of patients who had post-operative iritis longer than 1 month after cataract surgery during a 2-year period at Storm Eye Institute at the Medical University of South Carolina (MUSC) in Charleston, South Carolina. Routine cataract surgery results in the release of inflammatory mediators, leading to some degree of post-operative inflammation in all patients. This post-operative inflammation is usually controlled with topical steroid tapers and typically resolves by 1 month after surgery. In the presence of certain risk factors, such as a history of uveitis, this post-operative inflammatory period may be prolonged for weeks or months, punctuated by periods of “rebound” inflammation when topical steroid drops are tapered. Analysis of patients with this level of post-operative cell and low pre-operative RF titers revealed that 75% of these patients had diabetes [4]
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