Cataract surgery in uveitic eyes is often challenging and can result in intraoperative and postoperative complications. Most uveitic patients enjoy good vision despite potentially sight-threatening complications, including cataract development. In those patients who develop cataracts, successful surgery stems from educated patient selection, careful surgical technique, and aggressive preoperative and postoperative control of inflammation. With improved understanding of the disease processes, pre- and perioperative control of inflammation, modern surgical techniques, availability of biocompatible intraocular lens material and design, surgical experience in performing complicated cataract surgeries, and efficient management of postoperative complications have led to much better outcome. Preoperative factors include proper patient selection and counseling and preoperative control of inflammation. Meticulous and careful cataract surgery in uveitic cataract is essential in optimizing the postoperative outcome. Management of postoperative complications, especially inflammation and glaucoma, earlier rather than later, has also contributed to improved outcomes. This manuscript is review of the existing literature and highlights the management pearls in tackling complicated cataract based on medline search of literature and experience of the authors.
Serological studies are one of the important diagnostic tools used in the investigation of uveitis. This study was based on anti-toxoplasma serotitres obtained from 80 normal healthy adults and 122 patients investigated for ocular toxoplasmosis over a 42 month period. Fifteen per cent of normal healthy sera were found to have low titres (1:64 to 1:256), while 3.8% had high titres (1:1024 or higher). Thirty five eyes of 29 patients had presumed ocular toxoplasmosis based on clinical features and a typical fundal appearance. 89.6% of clinically positive ocular toxoplasmosis were found to have titres ranging from 1:64 to 1:4096. Among the suspected ocular tox oplasmosis cases with a serotitre more than or equal to 1:256, at least 77% had clini cal ocular toxoplasmosis.
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