Incidence and Risk Factors for Chronic Uveitis following Cataract Surgery

Kim, Stephen Jae; Chomsky, Amy; Saboori, Mazeyar

doi:10.3109/09273948.2012.752013

Cited by 15 publications

(13 citation statements)

References 15 publications

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“…The incidence of persistent iritis in our study was 0.32%, which is similar to that previously reported by Patel et al [3]. The incidence was 0.24% in Patel’s study with the exclusion criteria similar to those of our own study: duration of iritis less than 6 months, prior uveitis or underlying systemic disease, penetrating trauma, endophthalmitis, retained lens material, neovascular glaucoma, and prior intraocular surgery.…”

Section: Discussionsupporting

confidence: 90%

“…A study performed at Vanderbilt University found a significant association between postsurgical uveitis and intra-operative complications, as well as worse visual acuity outcomes. The median duration of inflammation was 10 months [3]. In a review of rheumatoid arthritis patients undergoing cataract surgery, elevated pre-operative rheumatoid factor (RF) serum titers were associated with 1+ aqueous cell 1 month after surgery.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the etiology of persistent iritis after cataract surgery

Neatrour

McAlpine

Owens

et al. 2019

J Ophthal Inflamm Infect

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Background The 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. Results Thirty-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. Conclusions Risk 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.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Evaluation of the etiology of persistent iritis after cataract surgery

Neatrour

McAlpine

Owens

et al. 2019

J Ophthal Inflamm Infect

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“…Hypopion was noted in one of our cases, this clinical feature was reported by several authors in approximately 46% of the cases of CPE (8, [11][12][13][14]. A white plaque on the anterior surface of the IOL or on the posterior capsule, was noted in all our patients, this nding was reported in 28.5% to 100% of CPE (11,14,15) and was found to be mostly associated with P.acnes (12,(16)(17)(18)(19)(20). Others clinical features were noted in literature, suggesting fungal infection, such as a stirringly white in ltrates or clumps in the anterior chamber (16,21,22).…”

Section: Discussionsupporting

confidence: 61%

Chronic Pseudophakic Endophthalmitis After Uneventful Phakoemulsification: A Case Series and Review of Litterature

Mili¹,

Braham

Kaouel³

et al. 2021

Preprint

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Purpose: To report a retrospective case series of patients with chronic post operative endophthalmitis (CPE) after uneventful phacoemulsification (PKE) with intraocular lens (IOL) implantation. Methods: this study was conducted between January 2011 and June 2020, including patients with delayed-onset endopthalmitis occurring at least 2 weeks after uneventful PKE+IOL. Diagnosis was based on typical clinical features associated or not to proven sample culture. Treatment was based on step-by-step management, depending on results of microbiology and response of treatment. It consisted in first line medical treatment with a two-approach intraocular and systemic antiobiotics, followed, if necessary, by a second line conservative-IOL surgical treatment with pars plana vitrectomy (PPV), and a third line non-conservative-IOL surgical treatment with re-PPV associated to IOL explantation. Results: Seven patients were included with a mean age of 62,5 years. Mean duration interval between cataract surgery and diagnosis of CPE was 31,3 weeks. All patients presented a decrease of visual acuity with white intracapsular plaques. Only one patient had positive IOL culture. Medical treatment was sufficient in three cases. In the four other cases, PPV with IOL explantation and total capsular bag removal was conducted. Mean final BCVA was 20/160 with a gain of 4 lines and was ≥ 20/40 in 4 cases. Conclusion: The diagnosis of CPE is still challenging especially for difficulties in isolating microorganisms. It should always be considered in cases of recurrent ocular inflammation resistant to conventional treatment in operated eyes. Non-conservative IOL surgical treatment may be directly necessary in severe cases.

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“…The first point is to always consider the intraocular lens position in patients with persistent anterior segment inflammation following cataract surgery. Chronic post-operative uveitis (persistent inflammation more than 6 months after cataract surgery) has been quoted as occurring in 1 in 400 operations with a much higher incidence in those eyes that had an intraoperative complication [ 6 ]. In our case the important signs of endothelial pigment deposition and inferior iris transillumination defects made us very suspicious that the intraocular lens may have been in the sulcus rather than in the capsular bag, and was therefore leading to iris chaffe and pigment shedding causing the persistent inflammation and high intraocular pressure.…”

Section: Discussionmentioning

confidence: 99%

Case report of secondary pigment dispersion glaucoma, recurrent uveitis and cystoid macular oedema following inadvertent implantation of an intraocular lens into the ciliary sulcus following cataract surgery

Porteous

Crawley

2018

BMC Ophthalmol

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BackgroundThis case highlights the important sequelae that can occur following the inadvertent implantation of a single-piece intraocular lens into the ciliary sulcus during cataract surgery; secondary pigment dispersion glaucoma, recurrent anterior uveitis and macular oedema.Case presentationA 67-year-old lady underwent routine left cataract surgery in a separate unit but subsequently attended our eye casualty with recurrent hypertensive anterior uveitis. She was found to have secondary pigment dispersion glaucoma as the intraocular lens had been inadvertently placed into the ciliary sulcus. She underwent a trabeculectomy to control the intraocular pressure and initially settled well but 12 months later developed persistent anterior segment inflammation and macular oedema. She subsequently had the intraocular lens removed and the macular oedema was treated successfully with intravitreal Bevacizumab.ConclusionsWe provide a summary of the evidence and a discussion over the management options available in managing such a difficult case.

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Incidence and Risk Factors for Chronic Uveitis following Cataract Surgery

Abstract: Postsurgical uveitis developed after approximately 1 in 400 cataract surgeries and occurred more frequently in eyes experiencing intraoperative complications.

Cited by 15 publications

References 15 publications

Evaluation of the etiology of persistent iritis after cataract surgery

Evaluation of the etiology of persistent iritis after cataract surgery

Chronic Pseudophakic Endophthalmitis After Uneventful Phakoemulsification: A Case Series and Review of Litterature

Case report of secondary pigment dispersion glaucoma, recurrent uveitis and cystoid macular oedema following inadvertent implantation of an intraocular lens into the ciliary sulcus following cataract surgery

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