Perioperative Management of Uveitic Cataracts

Chen, Judy L.; Bhat, Pooja; Lobo-Chan, Ann-Marie

doi:10.1016/j.yaoo.2019.04.014

Cited by 14 publications

(7 citation statements)

References 57 publications

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“…Cataract surgery in the setting of uveitis is known to be challenging and associated with higher risks of complications during surgery and the post-operative period. Nevertheless, consensus on optimal surgical procedures and treatments is lacking and randomized controlled trials are time-consuming and difficult to perform since uveitis is a relatively rare condition (Chen et al, 2019). Uveitis has been registered as a comorbidity in the NCR since 2018 and, in this setting, Note: Due to data availability at the eye level, between-group testing was performed using generalized estimating equations with uveitis/control group as the dependent variable and each characteristic as the independent variable, with a binomial distribution and logit-link function, adjusting for intraindividual correlation.…”

Section: Discussionmentioning

confidence: 99%

“…Cataract surgery in the setting of uveitis is known to be challenging and associated with higher risks of complications during surgery and the post‐operative period. Nevertheless, consensus on optimal surgical procedures and treatments is lacking and randomized controlled trials are time‐consuming and difficult to perform since uveitis is a relatively rare condition (Chen et al, 2019). Uveitis has been registered as a comorbidity in the NCR since 2018 and, in this setting, registry‐based studies offer an excellent opportunity to investigate current procedures in the Swedish population.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cataract surgery in patients with uveitis: Data from the Swedish National Cataract Register

Pålsson

Pivodic

Grönlund

et al. 2022

Acta Ophthalmologica

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Managing cataract in the setting of uveitis is known to require specific considerations, although there is no consensus on optimal treatments and surgical approaches (Jancevski & Foster, 2010;Sharief et al., 2018). Uveitis is classified based on anatomical localization (i.e. anterior, intermediate and posterior), with posterior uveitis being more frequently associated with coexisting retinal pathology and thus considered a more severe inflammatory disease. Consequently, cataract surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cataract surgery in patients with uveitis: Data from the Swedish National Cataract Register

Pålsson

Pivodic

Grönlund

et al. 2022

Acta Ophthalmologica

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“…Furthermore, the surgery is frequently 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 opacification, CME, recurrent or persistent inflammation, glaucoma, cyclitic and/ or epiretinal membrane development, and IOL dislocation [ 1 , 4 , 9 – 13 ]. It has been shown that delaying cataract surgery until best-corrected visual acuity (BCVA) significantly deteriorates may not be advisable.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors of cataract surgery in patients with uveitis

Jevnikar,

Počkar,

Umek

et al. 2023

Int Ophthalmol

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Purpose To evaluate the long-term visual outcomes of patients with uveitis undergoing cataract surgery and to identify possible factors influencing the visual prognosis and the development of postoperative complications. Methods Retrospective study of all patients with uveitis who underwent cataract surgery between January 2015 and February 2020 in our tertiary referral center. Results A total of 78 eyes from 78 patients were included in the study. The best-corrected visual acuity (BCVA) improved in 86% of patients, and a BCVA of 0.5 or better was achieved in 57 (73%) patients. A significant correlation was shown between the preoperative and postoperative BCVA (Spearman r = 0.521, p < 0.01). Final BCVA differed between diverse anatomical uveitis entities (p = 0.047), and anterior uveitis demonstrated the best outcomes. Chronic uveitis resulted in a worse final BCVA than acute recurrent uveitis (p = 0.001). The presence of CME any time before the surgery and intermediate uveitis were associated with worse visual prognosis, while systemic therapy for uveitis before surgery and iris manipulation during surgery were not related to visual outcomes. Postoperative development of cystoid macular edema (CME) was closely associated with preexisting CME (p < 0.001) and intermediate uveitis (p = 0.01). Conclusions Visual results of cataract surgery in patients with uveitis were beneficial, but limited visual outcomes were more frequently observed in patients with chronic uveitis and intermediate uveitis with a history of CME. In consequence, prevention, or adequate treatment of CME, especially in patients with intermediate uveitis, might result in better visual results of their cataract surgery.

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“…Since the younger population is affected, an excellent post-operative outcome is very important to diminish the disease burden. It is known that careful management of patients and well-controlled in ammation that needs to be silent for at least three months before the surgery is essential for a desirable outcome [2,3,8,9,13,14]. Nevertheless, postoperative outcomes may vary, and it has not yet been fully established why.…”

Section: Introductionmentioning

confidence: 99%

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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Perioperative Management of Uveitic Cataracts

Cited by 14 publications

References 57 publications

Cataract surgery in patients with uveitis: Data from the Swedish National Cataract Register

Cataract surgery in patients with uveitis: Data from the Swedish National Cataract Register

Prognostic factors of cataract surgery in patients with uveitis

Long-term Outcomes of Cataract Surgery in Patients With Uveitis

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