Long-term results of cataract extraction with intraocular lens implantation in patients with uveitis

Abstract

Objective To investigate the long-term visual results after cataract extraction in patients with uveitis, and to demonstrate the long-term viability of intraocular lenses. Design In all, 61 patients (72 eyes), with update clinical examination, were retrospectively evaluated. Comparison of preoperative, postoperative, and latest visual function including best-corrected Snellen visual acuity, progression of uveitis and its complications, need for postoperative medical or surgical interventions.Results After a minimum follow-up of 5 years (mean 7 years 7 months), 82% of eyes maintained a visual improvement of two Snellen lines, 74% maintained 6/9 or better, and 14% had 6/18 or worse. The mode acuity was better than 6/6. The prevalence of macular oedema or scarring was 24%, of posterior capsule opacification 96%, and of glaucoma drainage, 15%. Conclusions We report the long-term followup of cataract extraction and intraocular lens (IOL) implantation performed by a single surgeon on patients with uveitis attending a regional tertiary referral uveitis clinic. Using stringent perioperative and postoperative control of inflammation, patients with uveitis usually maintain high visual acuity over longterm follow-up. The incidence of sightthreatening postoperative complications is low and no ongoing complication has been attributed to IOL implantation.

Posterior capsule opacification following 20- and 23-gauge phacovitrectomy (posterior capsule opacification following phacovitrectomy)

“…Postoperative inflammation is linked to PCO development and has been extensively studied in uveitic eyes undergoing cataract surgery, with generally high rates of incidence being reported (ranging from 10 to 96%). 15,16 On the other hand, the incidence of PCO following 23-gauge phacovitrectomy in this study is higher than cataract surgery. Previous studies have reported that PCO developed more frequently after phacovitrectomy than after cataract surgery alone.…”

Phacoemulsification with intraocular lens implantation in patients with uveitis

“…In a study by Kawaguchi et al, 6 glaucoma developed in 8.4% of eyes after surgery. In a study by Rahman and Jones, 18 15.0% of patients required subsequent glaucoma drainage surgery. Our lower glaucoma rate may be the result of better control of surgery resulting from the use of the phacoemulsification technique with fixation of the IOL capsular bag.…”

“…Phacoemulsification in patients with visually significant cataract and uveitis other than Fuchs heterochromic uveitis have variable visual outcomes. [9][10][11][12][13][14][15][16][17][18][19] In this study, we excluded cases of Fuchs heterochromic uveitis because several studies have reported good surgical and visual outcomes in these cases. 7,8,21 In our series, successful phacoemulsification was completed in all cases and the IOL was implanted in the capsular bag except in 1 eye in which posterior capsule rupture occurred during I/A of the cortex.…”

“…Although good outcomes have been reported after cataract surgery in eyes with Fuchs heterochromic uveitis, 7,8 patients with visually significant cataract from other types of uveitis have variable postoperative outcomes. [9][10][11][12][13][14][15][16][17][18][19] In this study, we evaluated the outcomes of phacoemulsification with IOL implantation in patients with uveitis types other than Fuchs heterochromic.…”

Cataract Surgery Outcomes in Patients with Chronic or Recurrent Uveitis

“…This rate has been reported as 23.7% by Kawaguchi et al 31% by Estafounus et al and 96% by Rahman et al Hydrophilic acrylic intraocular lenses worked well in eyes with higher uveal biocompatibility, but PCO development was greater than in eyes with hydrophobic acrylic IOLs. 5,20,25,26 It is known that PCO development is seen least commonly with hydrophobic IOLs and with sharp optic edges. [26][27][28][29] A hydrophobic acrylic lens had been used in all our patients.…”