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Eliott Kim, David S Chu, Ashwinee Ragam; Visual Outcome of Cataract Surgery in Patients With Chronic Uveitis With or Without Intraocular Lens. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2803.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the value of Intraocular lens placement in patients with chronic uveitis who need to undergo cataract extraction for visual rehabilitation.
Through billing database for patients who had undergone complex cataract surgery from August 2001 to November 2013, we identified subjects who had active chronic inflammation due to noninfectious uveitis in the eye at the time of surgery. Subjects were divided into 2 groups; those who had posterior chamber intraocular lens (PCIOL) implant at the time of surgery (P) and those left aphakic intentionally (A). Statistically analysis of their visual outcome and degree of inflammation were performed and complicating factors were recorded.
331 charts were reviewed, and 27 subjects met study criteria and were reviewed in detail. 13 subjects were right eyes. Age ranged from 4 to 69, a mean age of 36 (SD = 21.25). 7 subjects were male. 9 patients had concurrent dexamethasone implant, 1 had concurrent corneal transplant, and 2 had concurrent pars plana vitrectomy. All had chronic noninfectious uveitis; 8 had sarcoidosis. 6 had juvenile idiopathic arthritis and 4 had Vogt-Koyanagi-Harada syndrome. 13 subjects belonged to group A and 14 to group P, of whom 2 underwent PCIOL removal sometime later. Among P, average logMAR best corrected pre-op visual acuity (VA) was 1.9 (SD = 0.9) and post-op VA was 1.4 (SD = 1.3), and the difference was not statistically significant (p = 0.18). Average anterior chamber cell reaction (ACC) pre-op was 0.2 (SD = 0.3) and average ACC post-op was 0.2 (SD = 0.4), with p = 0.75. Average anterior chamber flare (ACF) pre-op was 04 (SD = 0.5) and average ACF post-op was 0.5 (SD = 0.9), p = 0.44. Among A, average pre-op VA was 1.7 (SD = 1.2) and post-op VA was 0.6 (SD = 0.6), this difference was statistically significant (p = 0.00066). Average ACC pre-op was +0.3 (SD = 0.4) and average ACC post-op was 0 (SD = 0), p = 0.006. Average ACF pre-op was 0.5 (SD = 0.7) and average ACF post-op was 0.2 (SD = 0.4), p = 0.17. Average duration of follow-up was roughly the same between two groups.
Among patients with chronic noninfectious uveitis with active uveitis at the time of cataract surgery, patients appear to have better visual outcome if left aphakic. Furthermore, ACC was better controlled in patients in aphakic group.
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