Management of cataract in the setting of uveitis

Moshirfar, Majid; Somani, Anisha N.; Motlagh, Mahsaw; Ronquillo, Yasmyne C

doi:10.1097/icu.0000000000000626

Cited by 24 publications

(16 citation statements)

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“…CME has great negative impact on visual acuity, if it left untreated [33]. Management of postoperative and uveitic CME rely on the anti-inflammatory agents such as non-steroid anti-inflammatory drugs and corticosteroids; furthermore, immunomodulatory drugs may be required [33,34]. In the present study, we used topical non-steroid anti-inflammatory drugs and topical corticosteroids in combination for the initial treatment of CME.…”

Section: Cystoid Macular Edemamentioning

confidence: 99%

Phacoemulsification in patients with uveitis: long-term outcomes

et al. 2020

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Background: To assess the long-term outcomes of phacoemulsification and intraocular lens (IOL) implantation in eyes with uveitis. Methods: One hundred and five eyes of 81 patients, who underwent phacoemulsification and IOL implantation between January 2009 and July 2016, were included in this study. The demographic data, preoperative clinical findings, postoperative outcomes, and intraoperative and postoperative complications were recorded. All collected data and risk factors with regard to visual prognosis were analyzed with the help of the Statistical Package for the Social Sciences version 20.0 software program (IBM Corp., Armonk, NY, USA). Results: During follow-up (mean: 35.2 ± 22.2 months), corrected distance visual acuity (CDVA) improved in 87.7% of all eyes and reached a level of 0.3 LogMAR or greater in 61.3% of eyes. Postoperative complications included posterior capsule opacification (50.9%), posterior synechiae (21.7%), cystoid macular edema (16%), epiretinal membrane (13.2%), glaucoma (11.3%), increased intraocular pressure (8.5%), and severe inflammation (6.6%). Uveitis recurred in 55.7% of all eyes. The risk for the development of cystoid macular edema was found to be associated with recurrence in the early postoperative period. Low visual acuity risk was 11.1-fold higher with macular scarring (p = 0.001) and 14-fold higher with optic atrophy (p < 0.001), respectively. Conclusions: With appropriate management during the pre-and postoperative periods, phacoemulsification and IOL implantation surgery can be safe and effective in eyes with uveitis. However, great caution must be taken to prevent complications both before and after the surgery.

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Section: Cystoid Macular Edemamentioning

confidence: 99%

Phacoemulsification in patients with uveitis: long-term outcomes

et al. 2020

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“…Glucocorticoids are used in clinical routine to treat leukemias ( 1 , 2 ) and COVID-19 ( 3 ), for immunosuppression during solid organ transplantation ( 4 ), and in conjunction with cancer radiation therapy or, e.g., cataract surgery to reduce edema in critical areas ( 5 ). Dexamethasone exhibits a favorably 25-fold higher anti-inflammatory potency compared with cortisol ( 6 ), but the use of dexamethasone is limited by several dose-dependent side effects, including but not limited to osteoporosis and osteonecrosis ( 7 ), myopathy ( 8 ), peptic ulcers ( 9 ), and growth retardation ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Dexamethasone sensitizes to ferroptosis by glucocorticoid receptor–induced dipeptidase-1 expression and glutathione depletion

et al. 2022

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Dexamethasone is widely used as an immunosuppressive therapy and recently as COVID-19 treatment. Here, we demonstrate that dexamethasone sensitizes to ferroptosis, a form of iron-catalyzed necrosis, previously suggested to contribute to diseases such as acute kidney injury, myocardial infarction, and stroke, all of which are triggered by glutathione (GSH) depletion. GSH levels were significantly decreased by dexamethasone. Mechanistically, we identified that dexamethasone up-regulated the GSH metabolism regulating protein dipeptidase-1 (DPEP1) in a glucocorticoid receptor (GR)–dependent manner. DPEP1 knockdown reversed the phenotype of dexamethasone-induced ferroptosis sensitization. Ferroptosis inhibitors, the DPEP1 inhibitor cilastatin, or genetic DPEP1 inactivation reversed the dexamethasone-induced increase in tubular necrosis in freshly isolated renal tubules. Our data indicate that dexamethasone sensitizes to ferroptosis by a GR-mediated increase in DPEP1 expression and GSH depletion. Together, we identified a previously unknown mechanism of glucocorticoid-mediated sensitization to ferroptosis bearing clinical and therapeutic implications.

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“…290,1148 Cataract surgery and uveitis There are special issues to consider when patients with uveitis undergo cataract surgery. [1149][1150][1151] Patients with active inflammation, particularly those with anterior or intermediate uveitis, are at substantial risk for complications. A major potential problem, especially among patients with pre-existing iris damage or extensive posterior synechiae, is the development of adhesions between the iris and lens capsule postoperatively.…”

Section: P51mentioning

confidence: 99%