Risk of Refractive Prediction Error After Cataract Surgery in Patients with Thyroid Eye Disease

Caldwell, Anne Strong; Patnaik, Jennifer L; Ackerman, Melisa; Christopher, Karen L; Lynch, Anne M.; Singh, Jasleen

doi:10.2147/opth.s337360

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…Cataract extraction is one of the most common surgical procedures performed in the USA and around the world. Cataract surgery with modern phacoemulsification techniques is highly successful in the general population, with relatively high rates of improved postoperative best-corrected visual acuity (BCVA) [ 1 ], and low rates of complications such as intraocular pressure (IOP) elevation and persistent anterior uveitis (PAU) [ 2 ]. However, patients with pre-existing ocular inflammation or uveitis have higher rates of complications following cataract surgery [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Cataract Surgery Outcomes in Patients with Non-ocular Autoimmune Disease

Scott,

Nau,

Patnaik

et al. 2023

Ophthalmol Ther

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Introduction While phacoemulsification cataract extraction is generally highly effective and safe, patients with a history of uveitis are at higher risk for postoperative complications and often require a modified perioperative medication regimen. No data exists on risks of postoperative complications and persistent anterior uveitis (PAU) in patients with non-ocular autoimmune disease. Methods Medical records were reviewed of patients who underwent phacoemulsification cataract surgery with intraocular lens implantation between January 1, 2014 and December 31, 2019 at the University of Colorado Hospital (UCH) as part of a retrospective cohort study. Exclusion criteria included patient history of ocular inflammation and cataract surgery combined with another intraocular surgery. Patients were only included as having autoimmune disease if the diagnosis was confirmed by a relevant specialist at UCH. Patients with autoimmune disease were then stratified into systemic versus organ-specific autoimmune disease, and patients with systemic autoimmune disease were further stratified into immunosuppressed and not immunosuppressed at the time of cataract surgery. Patients with PAU were identified according to the Standardization of Uveitis Nomenclature Working Group. Data including sex, race/ethnicity, intraoperative cumulative dissipated energy (CDE), and postoperative best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were obtained. Results A total of 422 eyes from 248 patients had confirmed autoimmune disease, compared to a control group of 10,201 eyes. The autoimmune and systemic autoimmune disease groups were not more likely to have postoperative complications or PAU compared to the control group. Immunosuppression status among the systemic autoimmune disease group was also not associated with postoperative complications or PAU. Conclusion Patients with non-ocular autoimmune disease do not appear to be at higher risk for postoperative complications, including worse BCVA or increased rates of IOP elevation and PAU, following phacoemulsification cataract surgery. These patients do not appear to require modification of the typical perioperative medication regimen.

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Section: Introductionmentioning

confidence: 99%

Cataract Surgery Outcomes in Patients with Non-ocular Autoimmune Disease

Scott,

Nau,

Patnaik

et al. 2023

Ophthalmol Ther

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“…During surgery, manipulation of the periocular tissues or the globe, use of anesthetic agents that are known to be myotoxic, surgical stress, and post-operative infl ammation can all contribute to increasing the risk of precipitating TED in susceptible patients [21,24,25,27]. The percentage of patients with TED who undergo cataract surgery remains low [28]. Reactivation of TED after cataract surgery is a rare phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Acute vision threatening thyroid orbitopathy associated with cataract surgery: A case series and review of the literature

Christopher R,

Seanna R,

Kenneth A

2024

J Clin Res Ophthalmol

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Thyroid eye disease can be associated via cataract surgery with devastating visual consequences. A systematic review of the clinical records of patients with aggravation of their thyroid orbitopathy after eye surgery at a tertiary facility was performed. Patients who had worsening of their thyroid orbitopathy within the post-operative period of cataract surgery were included. Clinical findings were reviewed including clinical examination and imaging. A literature review was also performed. Two patients who underwent cataract surgery and presented with newly diagnosed and severe thyroid orbitopathy post-operatively were identified. Both patients were male, averaging 71 years of age. Both patients noticed symptoms of diplopia within one week after cataract surgery and had clinical and imaging findings consistent with severe thyroid orbitopathy. Both patients required urgent bilateral orbital decompression due to compressive optic neuropathy. Visual acuity was preserved in both patients. The average follow-up was 6 years. Males who have activation of TED after cataract surgery appear to have a higher risk of developing compressive optic neuropathy and require immediate intervention, which is consistent with male gender as a risk factor for severe disease. Patients with thyroid disease should be counselled pre-operatively about the risk of disease aggravation after cataract surgery.

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Practice patterns among ophthalmic surgeons in treating concomitant oculoplastic conditions in preoperative period: A questionnaire-based study

Panda,

Mishra,

Nayak

et al. 2025

World J Clin Cases

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BACKGROUND Addressing oculoplastic conditions in the preoperative period ensures both the safety and functional success of any ophthalmic procedure. Some oculoplastic conditions, like nasolacrimal duct obstruction, have been extensively studied, whereas others, like eyelid malposition and thyroid eye disease, have received minimal or no research. AIM To investigate the current practice patterns among ophthalmologists while treating concomitant oculoplastic conditions before any subspecialty ophthalmic intervention. METHODS A cross-sectional survey was disseminated among ophthalmologists all over India. The survey included questions related to pre-operative evaluation, anaesthetic and surgical techniques preferred, post-operative care, the use of adjunctive therapies, and patient follow-up patterns. RESULTS A total of 180 ophthalmologists responded to the survey. Most practitioners (89%) felt that the ROPLAS test was sufficient during pre-operative evaluation before any subspecialty surgery was advised. The most common surgical techniques employed were lacrimal drainage procedures (Dacryocystorhinostomy) (63.3%), eyelid malposition repair (36.9%), and ptosis repair (58.7%). Post-operatively, 47.7 % of respondents emphasized that at least a 4-week gap should be maintained after lacrimal drainage procedures and eyelid surgeries. Sixty-seven percent of ophthalmologists felt that topical anaesthetic procedures should be preferred while performing ocular surgeries in thyroid eye disease patients. CONCLUSION Approximately 50% of ophthalmologists handle prevalent oculoplastic issues themselves, seeking the expertise of an oculoplastic surgeon under particular conditions. Many ophthalmologists still favor using ROPLAS as a preliminary screening method before proceeding with cataract surgery. Eyelid conditions and thyroid eye disease are not as commonly addressed before subspecialty procedures compared to issues like nasolacrimal duct obstruction and periocular infections.

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Risk of Refractive Prediction Error After Cataract Surgery in Patients with Thyroid Eye Disease

Cited by 3 publications

References 29 publications

Cataract Surgery Outcomes in Patients with Non-ocular Autoimmune Disease

Cataract Surgery Outcomes in Patients with Non-ocular Autoimmune Disease

Acute vision threatening thyroid orbitopathy associated with cataract surgery: A case series and review of the literature

Practice patterns among ophthalmic surgeons in treating concomitant oculoplastic conditions in preoperative period: A questionnaire-based study

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