Efficacy of cataract surgery in patients with uveitis

Abstract

To evaluate the visual outcomes of cataract surgery in patients with uveitis, and to determine risk factors for the recurrence of uveitis and postoperative complications.Eighty patients with uveitis who underwent phacoemulsification with intraocular lens (IOL) implantation were included in this retrospective study. We analyzed the following data: patient characteristics, medications used, visual acuity, and complications of cataract surgery.The mean ± standard deviation time from cataract surgery to the last visit was 20.8 ± 10.4 months. Best-corrected visual acuity improved significantly after surgery (P < .001). The visual outcome was worse in patients with Behçet disease than in patients with other etiologies of uveitis. Gender (P = .018) and IOL type (P = .020) were significantly associated with recurrent uveitis after surgery. The incidence of recurrent inflammation was not significantly different between patients who did or did not receive systemic therapy (P = .43). Perioperative systemic therapies (P = .011) and recurrent uveitis within 3 months of surgery (P = .043) were associated with posterior capsular opacification. Perioperative systemic therapies (P = .026) and recurrent uveitis after surgery (P = .006) were also significantly associated with cystoid macular edema.Patients with uveitis could benefit from cataract surgery. Patients with Behçet disease had worse postoperative prognosis than patients with other etiologies of uveitis. A heparin-surface-modified IOL may reduce the incidence of recurrent inflammation.

Clinical Manifestations, Outcomes, and Histopathology of Recurrent Uveitis in Patients Underwent Pupil Coroplasty Combined with Cataract Surgery

“…Zhang Y et al have found that uveitis recurred in 14 eyes (18.9%) within 3 months and in ammation recurred in 34 eyes (45.9%) in the whole follow-up period [29]. Balta O et al have determined that the incidence of postoperative recurrence of uveitis was 52.7% in 48 patients underwent cataract surgery during 4 years of follow-up [1].…”

“…Balta O et al have found that the BCVA of 20/40 or better was achieved in 81.8% eyes (n = 18) in idiopathic anterior uveitis, 80.0% eyes (n = 8) in herpes simplex virusassociated anterior uveitis, 90.0% eyes (n = 9) in Fuchs' heterochromic iridocyclitis, and 100% (n = 13) in anterior uveitis associated with collagen vascular diseases over the 4 years of follow-up [1]. However, it is worth noting that uveitis is usually not quiescent after cataract surgery, and the recurrence of uveitis can be observed at an uncertain time [1,29].…”

Phacoemulsification in adult patients with post-uveitis complicated cataract

“…Cystoid macular edema occurs after surgery in the patients who suffered posterior capsule rupture (accidentally or by Nd-YAG laser capsulotomy); some authors state that perioperative systemic therapy is protective against those complications [ 6 , 7 ]. Prolonged eye inflammation after surgery is relatively rare, especially if heparin-surface-modified intraocular lenses are implanted [ 8 ]. Postoperative rising of intraocular pressure can occur frequently in these patients [ 2 , 9 ].…”

Recent Advances of Intraocular Lens Materials and Surface Modification in Cataract Surgery

“…It had been proved by experiments those materials with high hydrophilicity cause less postoperative inflammatory reactions due to reduced adhesion of surface cells and proteins ( Roesel et al, 2008 ). Therefore, HSM was thought to improve the uveal biocompatibility of the material, which had also been demonstrated in many clinical trials, especially for patients with preoperative uveitis ( Krall et al, 2014 ; Zhang et al, 2017 ). Unfortunately, HSM has not shown a special effect on the prevention of PCO ( Ronbeck and Kugelberg, 2014 ) through long-term observation.…”