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Catherine Origlieri, Yufei Tu, David Chu; Postoperative Visual Acuity Following Complicated Cataract Extraction In Uveitis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6701.
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© ARVO (1962-2015); The Authors (2016-present)
To compare preoperative and postoperative visual acuity (VA) in patients with uveitis and/or uveitic glaucoma undergoing complicated cataract extraction with intraocular lens implantation (CEIOL).
Through our surgical billing database, we identified 150 cases of complicated CEIOL performed at our institution from 2008 to 2010. Complete medical records were retrievable in 105 cases, including 32 cases of uveitis. Patient age at the time of surgery ranged from 9 to 88 years, and 62.5% were female. Diagnoses included sarcoidosis (n=6), sarcoidosis suspect (not biopsy confirmed, n=7), herpetic uveitis (n=5), Vogt-Koyanagi-Harada (VKH) syndrome (n=2), rheumatoid arthritis (RA, n=1), RA/Crohn’s disease (n=1), RA/systemic lupus erythematosus (SLE, n=1), Reiter’s syndrome (n=1), and uveitis not otherwise specified (n=8); three of the above eyes had concomitant uveitic glaucoma. Distance pinhole VA and manifest refraction, when documented in the medical record, were collected at postoperative months 1, 3, 6, and 12. Average length of follow-up was 11 months (range 4-27 months).
The above eyes underwent either isolated CEIOL (26 eyes), combined CEIOL with penetrating keratoplasty (PKP, 3 eyes), combined CEIOL with Ahmed valve implantation (2 eyes), or combined CEIOL with ethylenediaminetetraacetic acid (EDTA) chelation (1 eye). Twenty-five eyes (78.1%) demonstrated improved postoperative VA by postoperative month 1 and maintained either stable or continuously improving VA at all subsequent postoperative assessments. Five eyes (15.6%) had fluctuating postoperative VA but overall improved VA (by least 1 line) as of their most recent postoperative assessment compared to their preoperative baseline. The remaining two eyes (6.25%) had no light perception by postoperative month 12 from complications related to uveitic glaucoma and retinal detachment, respectively.
The stability of post-operative VA among patients with uveitis is promising. The majority of eyes in our study demonstrated improved postoperative VA above their preoperative baseline, with a low rate of postoperative complications. Additional follow-up will reveal whether this stability in VA is maintained in our study population.
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