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Chirag R. Patel, Stephen J. Kim; Incidence and Risk Factors for Chronic Uveitis Following Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4713.
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To determine the incidence rate of chronic uveitis developing after modern cataract extraction, establish predisposing risk factors, and assess long-term complications and visual outcomes.
This was a retrospective chart review of all patients that underwent cataract extraction at the Vanderbilt University Medical Center from January 1, 2002 to October 1, 2010. Patients were identified using Medicare billing codes for surgery (66982, 66984). Patients with uveitis were identified during the same period using ICD-9 codes (364.01, 364.02, and 364.10). For the purposes of this study, chronic uveitis was defined as persistent intraocular inflammation or continued need for immunosuppressive therapy for a minimum of six months after the date of cataract surgery. Patients were excluded if they had a history of uveitis prior to cataract surgery due to any cause.
A total of 13,165 cataract surgeries were performed and of these, 26 eyes of 22 patients developed chronic uveitis (0.2%). Seven of these eyes (27%) experienced intraoperative complications that included any or all of the following: posterior capsular rupture, unplanned vitreous loss with anterior vitrectomy, and unplanned placement of an intraocular lens in the sulcus or anterior chamber. Eight patients underwent consecutive cataract surgery in both eyes (< 4 weeks apart) and developed unilateral chronic uveitis. Four of these 8 eyes (50%) with chronic inflammation experienced intraoperative complications compared to 0 of the 8 fellow eyes that did not develop chronic inflammation (P < 0.05).
In this series, chronic uveitis following cataract surgery occurs in approximately 1 in 500 cases (0.2%) and eyes experiencing intraoperative complications appear to be at higher risk. More aggressive measures to prevent inflammation and limit its severity and duration in eyes with intraoperative complications may beneficially impact the risk of developing chronic uveitis.
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