Phacoemulsification with intraocular lens implantation in patients with uveitis

Abstract

To evaluate the outcomes of phacoemulsification with intraocular lens (IOL) implantation in eyes with uveitis. Tertiary care center, Chandigarh, India. Consecutive patients with uveitis and visually significant cataract were retrospectively studied for outcomes after phacoemulsification and implantation of a poly(methyl methacrylate) (PMMA) or a hydrophobic acrylic IOL. The study comprised 108 eyes of 81 patients (50 women, 31 men) with a mean age of 42.3 years +/- 13.98 (SD) (range 18 to 75 years) and a mean follow-up of 21.95 months (range 12 to 66 months). Etiology of uveitis was presumed tuberculosis (n = 24), Vogt-Koyanagi-Harada syndrome (n = 9), Behçet disease (n = 8), sarcoidosis (n = 5), ankylosing spondylitis (n = 4), serpiginous choroiditis (n = 2), and idiopathic (n = 29). The mean corrected distance visual acuity (CDVA) was 1.08 +/- 0.85 logMAR preoperatively and 0.42 +/- 0.78 D logMAR postoperatively; the improvement was statistically significant (P<.001, paired t test); Seventy-seven eyes (71.30%) achieved a CDVA between 0.00 logMAR and 0.30 logMAR (20/20 to 20/40 Snellen). Posterior capsule opacification (PCO) requiring neodymium:YAG capsulotomy occurred in 31 eyes (28.70%); posterior synechias in 27 eyes (25.00%); cystoid macular edema (CME) in 23 eyes (21.30%); recurrent uveitis in 6 eyes (5.55%); and epiretinal membrane formation, glaucoma, and iris bombe in 5 eyes (4.63%) each. Phacoemulsification with IOL implantation improved vision in most patients with coexisting cataract and uveitis. The main complications affecting visual outcomes were macular involvement, CME, PCO, and glaucoma. No author has a financial or proprietary interest in any material or method mentioned.