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Kei Takayama, Sayuri Fujii, Syo Ishikawa, Masaru Takeuchi; Outcome of Cataract Surgery for Endogenous Uveitis without Postoperative Systemic Steroid Medication. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6686.
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© ARVO (1962-2015); The Authors (2016-present)
Cataract development is a common sight-impairing complication of uveitis. Phacoemulsification with posterior intraocular lens (IOL) implantation has been the standard treatment for uveitis-associated cataract, and systemic steroid for postoperative ocular inflammation is not always necessary. In this study, we investigated the outcome of cataract surgery in patients with endogenous uveitis in remission, without receiving postoperative systemic steroid therapy.
We retrospectively reviewed the medical records of 17 patients (25 eyes) with chronic endogenous uveitis who underwent phacoemulsification with IOL implantation between January 2010 and May 2011. The average age was 73.3 years (range 62-83). The underlying uveitic entities were sarcoidosis in 9 eyes; Behcet disease, Vogt-Koyanagi-Harada disease, rheumatic arthritis, Fuchs' heterochromic cyclitis, and acute anterior uveitis in 2 eyes each; HSV iridocyclitis, VZV iridocyclitis and Toxoplasma uveitis in 1 eye each; and unknown causes in 3 eyes.. In all patients, surgery was performed after at least 3-month remission, during which no systemic medications were given. The incisions were 2.2 to 2.4 mm, and foldable acrylic lens were implanted. Best-corrected visual acuity (BCVA) was recorded at the immediate preoperative visit and at postoperative follow-up examinations at 1 week, 1 month, 3 months, and then every 3 months. The mean postoperative observation period was 4.5 months, and a complete ophthalmologic examination was performed at each postoperative visit.
The mean log MAR converted from BCVA was -0.44 before cataract surgery, and decreased significantly to -0.8 at 1 week and to 0.94 at the final visit after surgery. The mean ocular tension was 15 mmHg before operation, and was 14.7 mmHg at 1 week after surgery and 11 mmHg at the final visit. Activity of ocular inflammation was unchanged clinically from before to the last visit after operation. Although severe recurrent uveitis was observed in 1 eye and high ocular pressure in 1 eye, these postoperative complications were resolved with increasing numbers of steroid eye drops.
These results indicate that phacoemulsification with posterior IOL implantation performed for uveitis-associated cataract does not deteriorate the activity of uveitis and may not require postoperative systemic steroid therapy.
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