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Eric Liss, Asima Bajwa, James Patrie, Wenjun Xin, Ashvini Reddy; Characteristics, Management, and Outcomes of Non-infectious Post-Procedural Uveitis in a Tertiary Care Center. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5769.
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To report the characteristics, management, and outcomes of noninfectious, post-procedural uveitis seen in a tertiary care center over a 30-year period.
A retrospective chart review was performed on a database of 492 eyes diagnosed with uveitis over a 30-year period. From this larger cohort, 39 eyes from 36 patients were identified as having non-infectious, post-procedural uveitis (defined as ocular inflammation following intraocular surgery, laser, or intravitreal injection). Descriptive statistics were used to analyze and characterize the type of procedures involved, anatomic location of inflammation, medical management, surgical management, and visual acuity (VA).
Of the 39 eyes identified, 19 (48.7%) were diagnosed post-cataract extraction and IOL placement, 4 (10.3%) were post-intravitreal injection, 6 (15.4%) were post-cornea surgery, 3 (7.7%) were post-laser procedures, 6 (15.4%) were post-retina surgery, and 1 (2.6%) was following glaucoma surgery. No patients were diagnosed with infection. There were 33 cases of anterior uveitis (84.6%) and 6 cases of panuveitis (15.4%). All patients required treatment for inflammation, with 34 (87.2%) using topical steroids, 3 (7.7%) using systemic steroids, 9 (23.1%) using intravitreal or sub-tenon’s injection, and 2 (5.2%) taking a systemic anti-metabolite agent. Mean baseline VA was 0.759 logMAR (20/115 Snellen) and mean final VA was 0.849 (20/140 Snellen) with a p value of <0.05. Final VA was decreased by one line or more in 17 (43.6%) eyes. Additional interventions included cataract extraction in 28 (71.8%) eyes, medical management of increased IOP in 11 (28.2%) eyes, and glaucoma surgery in 2 (5.1%) eyes.
Post-procedural uveitis can present following intraocular surgery, laser therapy, or intravitreal injection, and patients may require long-term steroids or steroid-sparing therapy for control. It is also associated with secondary issues such as cataract formation and IOP elevation. In this series, post-procedural uveitis was associated with a clinically and statistically significant decrease in final visual acuity relative to presentation.
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