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Anne-Laure Remond, Emmanuelle Champion, Valérie Touitou, Christine Fardeau, Bahram Bodaghi, Phuc Le Hoang; Cataractogenesis and surgical outcome in patients with uveitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2995.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the risk of cataract development, the surgical management and the prevalence of complications in 2 groups of patients with uveitis treated in 2000 and 2010 in a tertiary eye care centre.
Retrospective study of patients with uveitis referred to an academic centre for the diagnosis and treatment of uveitis. An extensive work-up based on clinical presentation was performed when necessary. Corticosteroids were the mainstay of therapy in 2000 but new immunosuppressive molecules were used in 2010. Two groups were analyzed based on the year of cataract surgery (group A: 2000 and group B: 2010). Demographic factors, delay between onset of uveitis and cataract surgery, age at the time of surgery, post-surgical improvement of visual acuity and major complications were studied. Phacoemulsification and intraocular lens implantation were performed in all cases respecting a 3-month quiescence of uveitis and an efficient perioperative anti-inflammatory regimen.
The study included 112 eyes of 96 patients. 51 eyes (42 patients: Women/Men Rate: 1.33) were operated in 2000 (group A) and 61 (54 patients: w/m R: 1.45) were operated in 2010 (group B). An associated condition was determined in 81 cases (84.38%): mainly herpetic uveitis (11), sarcoidosis (9), tuberculosis (8), birdshot chorioretinopathy (6), Behcet's disease (6), spondyloarthropathy (9), Vogt-Koyanagi-Harada disease (4), multiple sclerosis (3), Fuchs heterochromic iridocyclitis (8), toxoplasmosis (2). Average age at the time of surgery was 50.3 years in group A and 57.3 years in group B. Delay between onset of uveitis and cataract surgery was 4.8 years in group A and 9.4 years in group B (p<0.04). Eyes having a BCVA ≤20/60 before and after surgery are 39 and 14 respectively in group A (76.47-27.45%); 32 and 12 respectively in group B (52.46-19.67%). Main complications were: high IOP: 10 eyes in group A (19.61%) and 7 eyes in group B (11.48%); early uveitis relapse: 6 eyes in group A (11.76%) and 9 eyes in group B (14.75%); macular edema: 2 eyes in group A and 5 eyes in group B.
During a 10-year period, the management of uveitis has strongly improved. Delay between onset of disease and cataract surgery has increased. Thus, cataract development seems to be slower and treatment of uveitis much more effective. Better management of ocular inflammation based on biologic agents may delay cataractogenesis in young and active patients with uveitis.
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