Postoperative Inflammation after Cataract Surgery in Patients with Rheumatoid Arthritis

Abstract

The purpose of the present study was to assess the influence of preoperative activity of rheumatoid arthritis (RA) on early postoperative anterior chamber inflammation after phacoemulsification and intraocular lens implantation. Twenty-three eyes in 18 patients were included in our study. On the first postoperative day, anterior chamber inflammation was observed in 11 eyes (47.8%). Five days after surgery, we found postoperative inflammation only in 1 eye (4.3%). Keratic precipitates were observed in 1 eye (4.3%) on the second postoperative day. We found no correlation between the extent of anterior chamber inflammation and the preoperative activity of RA. Postoperative anterior chamber inflammation was also not associated with the medical management of RA.

Laser in situ keratomileusis in patients with autoimmune diseases

“…Jones and Maguire 16 report a series of 86 cataract extractions in 70 patients with rheumatoid arthritis in which none of the eyes developed corneal or scleral melts, suggesting that the added risk of cataract surgery is low. Pahor et al 17 report a series of 23 eyes of 18 rheumatoid arthritis patients who had phacoemulsification without complications. They noted a higher level of postoperative anterior chamber inflammation in the early postoperative period that resolved in all cases.…”

Cataract surgery in adult eyes with short axial length

“…A cohesive ophthalmic viscoelastic device (OVD) usually suffices for mild cases. In severe cases, preoperative administration of an intravenous 20% mannitol, can help reduce the vitreous volume and decrease the positive vitreous pressure [35]. Another maneuver is to perform a limited pars-plana vitrectomy using a high cutting low vacuum setting to remove a small amount of vitreous and deepen the AC [36].…”

Posteriore Kapselopazifikation nach Phakoemulsifikation bei Patienten mit rheumatoider Arthritis

“…Die Phakoemulsifikation bewirkt wenigere Blutkammerwasserschrankenzusammenbrüche während des ersten postoperativen Monats als die extrakapsuläre Kataraktextraktion [24,25]. Eine Vorderkammerentzündung verursacht einen Blutkammerwasserschrankzusammenbruch.…”

“…Die Ergebnisse dieser und anderer Studien suggerieren, dass bei Patienten mit einer RA die Phakoemulsifikation als sicheres Verfahren angesehen werden kann [24,25].…”

“…Eine geringere PCO-Häufigkeit verlangt eine geringere ND: YAG-Kapsulotomiehäufigkeit [7,9,21] [22,23]. Die Kataraktchirurgie mit Implantierung wird bei RA-Patienten ohne vorherige Augenentzündung als sicheres Verfahren angesehen [24,25]. Einige die Retroillumination anwendenden Systeme sind zur objektiven Quantitätsbestimmung der PCO entwickelt worden [4,5,26].…”