Phacoemulsification in uveitic cataract at a tertiary care teaching center

Abstract

Introduction: Due to variation in etiology and presentation, it is difficult to predict the outcomes of phacoemulsification in patients suffering from uveitis. The present study evaluated outcomes of surgery at a tertiary care teaching hospital. Materials and Methods: 64 eyes of 64 patients with uveitis were retrospectively studied for vision related outcome and complication rate after phacoemulsification surgery. However, after exclusion, 46 eyes were analysed. Results: The mean age of patients with uveitis enrolled was 46.7±2.3 (range, 28-56 years). The mean duration of follow-up was 12.6±3.4 (range, 8-16 months). Improvement in vision was significantly better in males (P=0.05). Uveitis was silent for 6.3±2.6 months prior to performing surgery. Tuberculosis was the most commonly identified etiological factor followed by Fuch’s iridocyclitis and Vogt’s Koyanagi Harada disease, respectively. The frequent complications of surgery were recurrent uveitis, cystoid macular edema and after-cataract. Factors influencing vision were location of uveitis, intake of preoperative steroids and posterior segment pathology. At final follow-up, the vision was 0.24±0.07 Log MAR units. Conclusion: Thorough control of inflammation prior to performing surgery is the key to good visual outcome in uveitis. Phacoemulsification with posterior chamber IOL implantation provided good vision when the inflammation is confined to the anterior segment of the eye. Visual prognosis compromise in diseases involving the central fundus. Keywords: Cataract, Cystoid macular oedema, Intraocular lens implantation, Posterior capsule opacification, Uveitis, Vision.