Long-term results of cataract surgery in patients with anterior uveitis

Balta, Özgür; Sungur, Gülten; Acar, Mehmet Akif; Yakin, Mehmet; Örnek, Firdevs

doi:10.1007/s10792-017-0598-z

Cited by 14 publications

(22 citation statements)

References 31 publications

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“…The nal BCVA of 0.5 or higher was achieved in 71.5% of eyes which is comparable to previously reported data, where the nal BCVA ranged from 47-87.3% [2-4, 9, 10, 12, 14, 16]. The highest percentage of eyes achieving BCVA 0.5 or better was seen in anterior uveitis, which is in line with previous reports [2,4,9,10,14,16]. However, 65.3% of patients with intermediate uveitis achieved BCVA 0.5 or better, which is better than previously reported.…”

Section: Discussionsupporting

confidence: 91%

“…It develops due to a combination of prolonged in ammation and treatment with corticosteroids and affects 50-70% of patients [1][2][3]. As opposed to age-related cataracts, patients with uveitis tend to be younger, often exhibiting co-pathology such as cystoid macular edema (CME) and elevated intraocular pressure (IOP) [4][5][6][7][8]. Furthermore, the surgery is more challenging due to miotic pupil, posterior synechiae, iris atrophy, zonular weakness, and pupillary membrane [1,4,9,10].…”

Section: Introductionmentioning

confidence: 99%

“…As opposed to age-related cataracts, patients with uveitis tend to be younger, often exhibiting co-pathology such as cystoid macular edema (CME) and elevated intraocular pressure (IOP) [4][5][6][7][8]. Furthermore, the surgery is more challenging due to miotic pupil, posterior synechiae, iris atrophy, zonular weakness, and pupillary membrane [1,4,9,10]. The most common postoperative complications include posterior capsule opaci cation, cystoid macular edema, recurrent or persistent in ammation, glaucoma, epiretinal membrane, and IOL dislocation 1, 4, 9-13.…”

Section: Introductionmentioning

confidence: 99%

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Long-term Outcomes of Cataract Surgery in Patients With Uveitis

Jevnikar¹,

Počkar

Umek

et al. 2022

Preprint

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Purpose: The aim of this retrospective study was to evaluate the long-term visual outcomes of patients with various etiologies of uveitis, undergoing cataract surgery and to identify possible factors influencing the visual outcome and the rate of postoperative complications. Methods: Patients who underwent cataract surgery between January 2015 and February 2020 were included. Results: A total of 102 eyes of 78 patients were included in this study. There was a statistically significant difference in the postoperative BCVA between the groups based on anatomical localization as well as etiology. Standard procedure with phacoemulsification and lens implantation was associated with statistically significant better final BCVA than surgery with an additional iris procedure. Conclusions: Visual outcome varies between the subtypes of uveitis. Post-operative BCVA correlates strongly with preoperative values; prolonged delay of surgery may not be indicated. Meticulous control of pre-operative inflammation, peri-operative treatment adjustment, and close postoperative follow-up is essential for a favorable outcome.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term Outcomes of Cataract Surgery in Patients With Uveitis

Jevnikar¹,

Počkar

Umek

et al. 2022

Preprint

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“…The risk is even higher in uveitic eyes[ 87 90 97 ] especially in younger patients. [ 49 98 ] The incidence of PCO in uveitic eyes is 34.2-81.7%[ 96 97 99 ] and 3.6-32.2% require Nd:YAG capsulotomy. [ 96 97 99 ] Nd:YAG capsulotomy is indicated when the visual acuity is reduced or when visibility of the posterior segment is compromised due to PCO.…”

Section: Postoperative Complicationsmentioning

confidence: 99%

Decision-making and management of uveitic cataract

Chan

Chee

2017

Indian J Ophthalmol

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The visual outcome of uveitic cataract surgery depends on the underlying uveitic diagnosis, the presence of vision-limiting pathology and perioperative optimization of disease control. A comprehensive preoperative ophthalmic assessment for the presence of concomitant ocular pathology, with particular emphasis on macula and optic nerve involvement, is essential to determine which patients will benefit from improved vision after cataract surgery. Meticulous examination in conjunction with adjunct investigations can help in preoperative surgical planning and in determining the need for combined or staged procedures. The eye should be quiescent for a minimum of 3 months before cataract surgery. Perioperative corticosteroid prophylaxis is important to reduce the risk of cystoid macular edema and recurrence of the uveitis. Antimicrobial prophylaxis may also reduce the risk of reactivation in eyes with infectious uveitis. Uveitic cataracts may be surgically demanding due to the presence of synechiae, membranes, and pupil abnormalities that limit access to the cataract. This can be overcome by manual stretching, multiple sphincterotomies or mechanical dilation with pupil dilation devices. In patients <2 years of age and in eyes where the inflammation is poorly controlled, intraocular lens implantation should be deferred. Intensive local and/or oral steroid prophylaxis should be given postoperatively if indicated. Patients must be monitored closely for disease recurrence, excessive inflammation, raised intraocular pressure, hypotony, and other complications. Complications must be treated aggressively to improve visual rehabilitation. With proper patient selection, improved surgical techniques and optimization of peri- and post-operative care, patients with uveitic cataracts can achieve good visual outcomes.

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“…In fact, few studies have looked at IOP outcomes in eyes with uveitis undergoing cataract surgery. Balta et al found that 9 of 55 eyes with uveitis that underwent cataract surgery had elevated IOP [ 16 ]. Mora et al studied 52 eyes, and although average 2-week postoperative IOP was elevated, IOP at final follow-up was not significantly different than baseline [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Timing of Quiescence and Uveitis Recurrences After Cataract Surgery in Patients with a History of Uveitis

et al. 2021

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Introduction: In patients with a history of uveitis, a 60-90-day period of quiescence prior to cataract surgery has been historically recommended. These recommendations were based mostly on expert opinion. The purpose of this study was to further examine and understand uveitis quiescence timing and outcomes of eyes that do have a recurrence of uveitis after cataract surgery. Methods: Patients with a history of uveitis undergoing cataract surgery at the University of Colorado Sue-Anschutz Rodgers Eye Center from 2014 to 2018 were studied. Main outcome measures were best corrected visual acuity (BCVA) at 6 months, intraocular pressure (IOP) at 6 months, and recurrences of uveitis within 90 days of surgery. Timing of cataract surgery in relation to preoperative uveitis quiescence was recorded.Results: A total of 149 eyes from 114 patients were included. Uveitis recurrence was seen in 31 (20.8%) of the 149 eyes with a history of uveitis undergoing phacoemulsification. The mean logMAR change or improvement in vision was 0.429 in eyes with a recurrence of uveitis, and 0.318 in eyes without, a difference that was not statistically significant (p = 0.292). Eyes with a recurrence of uveitis displayed higher IOP at 6 months compared to eyes without a recurrence, at 16.1 versus 13.0 mmHg respectively (p = 0.0009). Eyes that were quiescent for 30 days or less were more likely to have a uveitis recurrence (OR 6.11, 95% CI 2.48-15.06, p = 0.0001). Conclusions: Our study shows that a quiescence period of at least 30 days is beneficial in reducing uveitis recurrence after cataract surgery. It is unclear what the long-term consequences of a uveitis recurrence after cataract surgery are, though it appears there may be elevated IOP in patients with recurrences, and thus patients with a history of uveitis should be counseled carefully about this potential risk.

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Long-term results of cataract surgery in patients with anterior uveitis

Abstract: The long-term outcomes of phacoemulsification with intraocular lens implantation in patients with uveitic cataract were satisfactory with excellent visual acuity and relatively low complication rates.

Cited by 14 publications

References 31 publications

Long-term Outcomes of Cataract Surgery in Patients With Uveitis

Long-term Outcomes of Cataract Surgery in Patients With Uveitis

Decision-making and management of uveitic cataract

Timing of Quiescence and Uveitis Recurrences After Cataract Surgery in Patients with a History of Uveitis

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