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Tania Albavera-Giles, Juan Carlos Serna-Ojeda, Miguel Pedroza-Seres; Cataract surgery in patients with pars planitis and immunosuppressive therapy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5798.
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To evaluate the characteristics and outcomes of cataract surgery in patients with pars planitis who received immunosuppressive therapy in a tertiary institution of ophthalmology in Mexico.
We reviewed our database between January 2003 and November 2014 of 374 patients with pars planitis, and from the 49 patients that received immunosuppressive therapy, we included the patients with cataract surgery. A retrospective analysis was performed, and the following data was collected: age at presentation, age at cataract surgery, follow-up, visual acuity before, 1 week, 1 month and 6 months after the surgery, inflammation after the surgery, immunosuppressive therapy used for each case, surgical and postoperative complications and causes for failed visual improvement.
Sixteen patients were included, with a median age at presentation of 10.5 years and with a median age at the moment of the cataract surgery of 11 years (range 4-26 years). All the patients had no inflammation before the surgery for at least 2 months. The immunosuppressive therapy used for the patients were methotrexate in 15 patients (93.7%) and azathioprine in 6 (37.5%), with 5 patients requiring a combination of drugs. Thirteen patients received the immunosuppressive therapy before the surgery for a median time of 8 months, and 3 patients received only previously systemic steroids, and the immunosuppressors were administered after the surgery. All the patients had phacoemulsification with intraocular lens implantation in the capsular bag in 15 patients (93.7%) and 9 patients (56.25%) required anterior vitrectomy. The visual acuity improved from a median of 20/800 (range 20/60 to hand movements), to 20/100 (range 20/25 to 20/2000) after 6 months of follow up; 14 patients (87.5%) improved two lines of vision or more and the other 2 patients remained the same visual acuity. No improvement in visual acuity was attributed to posterior segment manifestations or amblyopia. The median follow up after the surgery was 32 months (range 4 to 91 months) and with immunosuppressive therapy was 18 months (range 2 to 56 months).
Phacoemulsification was the procedure for all the patients in this study, with a high rate of anterior vitrectomy. Visual acuity improved in 87.5% of patients with pars planitis treated with immunosuppressive drugs who underwent cataract surgery.
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