Management of coincident cataract and uveitis

Foster, C. Stephen; Rashid, Saadia

doi:10.1097/00055735-200302000-00001

Cited by 76 publications

(65 citation statements)

References 31 publications

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“…Cataract surgery in uveitis now carries an excellent visual prognosis [88, 89]. With the exception of lens-induced (phakolytic) uveitis, where cataract surgery is carried out as soon as possible, and Fuchs’ heterochromic uveitis syndrome [90, 91, 92], cataract surgery is usually only contemplated when the eye has been free of active inflammation for a minimum of 3 months, thus the patient may have to suffer many months of poor vision before surgery is undertaken [93, 94]. …”

Section: Epidemiology Of Uveitismentioning

confidence: 99%

Uveitis: A Potentially Blinding Disease

Durrani¹,

Meads

Murray³

2004

Ophthalmologica

264

170

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Uveitis (intraocular inflammation) is a potentially blinding group of, probably autoimmune, conditions predominantly occurring in the working age group. Although the aetiology is unknown in most cases, many patients have an associated underlying systemic disease. Central vision loss, in the form of cystoid macular oedema, is the commonest type of visual impairment. Although historical incidence and prevalence data exists, little is known about the degree of vision loss experienced, and the social and financial consequences of having temporary or permanent visual impairment in this age group. The literature is also full of uncontrolled studies and case reports of different modalities of drug therapy for uveitis. This article attempts to raise the awareness of uveitis as an important sight-threatening group of conditions by highlighting the paucity of evidence-based data on epidemiological, quality of life, socioeconomic, and therapeutic aspects.

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Section: Epidemiology Of Uveitismentioning

confidence: 99%

Uveitis: A Potentially Blinding Disease

Durrani¹,

Meads

Murray³

2004

Ophthalmologica

264

170

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“…The most important step in the management of complicated cataract is adequate pre-operative control of the inflammation (Foster et al, 2003). Most authors consider the absence of cells in the anterior chamber synonymous with inflammatory control, as mild cellular reaction in the vitreous persist even in the inactive stage of FHI (Tan et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Small-incision cataract surgery in patients with Fuch’s heterochromic iridocyclitis

Bhargava

Kumar

Sharma³

et al. 2014

Nep J Oph

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Introduction: Fuch's heterochromic iridocyclitis (FHI) is often complicated by cataract formation. Objective: To assess the results of small-incision cataract surgery (SICS) in FHI and to study the effect of preoperative factors on postoperative vision. Materials and methods: Sixty-three eyes of 59 patients with Fuchs heterochromic iridocyclitis who had SICS with in-the-bag implantation of intraocular lens (IOL) were evaluated retrospectively; and the primary and secondary outcome measures evaluated were the postoperative vision and complication rate. Results: The mean age was 39.22 ± 4.95 years. The mean pre-operative vision was 0.75 ± 0.24 Log MAR units. The mean final vision was 0.27 ± 0.10 Log MAR units (P = < 0.001). At the final follow-up, 84.1 % of the patients had a final Snellen's vision of 6/12 or better. The mean follow-up period was 12.06 ± 2.06 months. The causes of corrected distance visual acuity (CDVA) worse than 6/60 were vitreous opacities, posterior keratic precipitates (KPs), glaucoma, persistent uveitis and cystoid macular edema (CME). Preoperative factors like iris atrophy (P = 0.973), heterochromia (P = 0.10) and vessels in angle (P = 0.074) did not have a significant effect on the final vision. On the contrary, vitreous opacities (P = 0.002) and posterior KPs (P = 0.009) had a significant effect on the final visual outcome. Conclusion: SICS with in-the-bag implantation of IOL in patients with Fuch's heterochromic iridocyclitis resulted in good visual outcomes. SICS in complicated cataracts can be performed in rural settings and eye camps with minimal instrumentation, obviating the need for referral to tertiary care centres. Pre-operative factors like vitreous opacities and posterior KPs have a significant effect on the final vision.

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“…It has been reported that hydrophobic acrylic lenses have the best capsular biocompatibility and that hydrophilic acrylic lenses exhibit the best uveal biocompatibility [10]. Some studies have suggested that IOLs with PMMA or acrylic optics are more favorable in uveitic patients [11,12]. Decreased incision size and reduced contact between IOL and uveal tissue appear significant for preventing postoperative inflammation [10,13,14].…”

Section: Discussionmentioning

confidence: 99%

Phacoemulsification and Core Vitrectomy in Fuchs’ Heterochromic Uveitis

et al. 2017

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Objective: To evaluate the efficacy of phacoemulsification combined with posterior capsulorhexis, core vitrectomy and ciliary sulcus intraocular lens (IOL) implantation in patients with Fuchs' heterochromic uveitis (FHU). Materials and Methods:A total of 18 eyes of 18 patients with FHU underwent cataract surgery were included in the study. 18 eyes with FHU underwent posterior capsulorhexis, core vitrectomy and poly (methyl methacrylate) (PMMA) IOL implantation in the ciliary sulcus. Subjects were chosen for this procedure based on an intraoperative vitreous haziness assessment, performed by indirect ophthalmoscopy. Patients with +2 or more vitreous haziness qualified for this procedure.Results: Of the 83 eyes with FHU that underwent cataract surgery, 18 eyes (21.6%) of 18 patients were employed in the study. There were 11 (61.1%) men and 7 (38.9%) women in the study; ages ranged from 23 to 47, with a mean of 32.06 years. Follow-up ranged from 8 months to 49 months. There were no intraoperative complications except for peripheral iris bleeding in 7 eyes. There was no severe intraocular inflammation in any patient postoperatively. All patients had 0.05 or better logMAR visual acuity after corneal suture removal. Glaucoma developed in 2 patients. For the short term period, the main vision threatening problem was suture-induced astigmatism.Conclusion: Cataract surgery combined with posterior capsulorhexis, core vitrectomy and IOL implantation in the ciliary sulcus is safe and leads to good visual outcome due to the removal of the hazy vitreous in patients with FHU.Keywords: Phacoemulsification, Fuchs' heterochromic uveitis, core vitrectomy ÖZ Amaç: Bu çalışmada Fuchs' heterokromik üveiti (FHÜ) olan hastalarda arka kapsüloreksis, kor vitrektomi ve silier sulkusa intraoküler lens (İOL) implantasyonu ile kombine fakoemülsifikasyon cerrahisinin etkinliğini değerlendirmek amaçlanmıştır.Gereç ve Yöntem: Fuchs' heterokromik uveiti olan ve katarakt cerrahisi uygulanan 18 hastanın 18 gözü çalışmaya alındı. FHÜ olan 18 göze; arka kapsüloreksis, kor vitrektomi ve silier sulkusa polimetilmetakrilat (PMMA) İOL implantasyonu uygulandı. İntraoperatif, indirekt oftalmoskop ile vitreusta bulanıklık derecesi değerlendirilerek; +2 veya daha fazla vitreus bulanıklığı olan hastalar bu prosedüre dahil edildi.Bulgular: Fuchs' heterokromik üveiti olan ve katarakt cerrahisi uygulanan 83 gözün 18'i (%21,6) çalışmaya dahil edildi. 23 ile 47 yaş aralığında (ortalama 32.06 yıl) olan hastaların 11'i (%61,1) erkek, 7' si (%38,9) kadın idi. Hastaların takip süresi 8 ay ile 49 ay arasında değişmekteydi. 7 gözde gelişen iris periferinde kanama dışında; intraoperatif herhangi bir komplikasyon görülmedi. Hiçbir hastada postoperatif şiddetli intraoküler inflamasyon görülmedi. Korneal sütürler alındıktan sonra, tüm hastalar logMAR' a göre 0,05 veya daha iyi seviyede görme keskinliğine sahipti. 2 hastada glokom gelişti. Kısa dönemde görme seviyesini etkileyen ana problem sütüre bağlı astigmatizma idi.Sonuç: Fuchs' heterokromik uveiti olan hastala...

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Management of coincident cataract and uveitis

Cited by 76 publications

References 31 publications

Uveitis: A Potentially Blinding Disease

Uveitis: A Potentially Blinding Disease

Small-incision cataract surgery in patients with Fuch’s heterochromic iridocyclitis

Phacoemulsification and Core Vitrectomy in Fuchs’ Heterochromic Uveitis

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