Purchase this article with an account.
Nicole R. Benitah, Ann-Marie Lobo, George N. Papaliodis; Outcomes of Complicated Cataract Extractions in Uveitic Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6219.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Of the many complications resultant from intraocular inflammation, one of the most damaging to vision can be the uveitic cataract. On the other hand, one of the most dramatic improvements in vision a uveitis patient may experience is the appropriate surgical treatment of their cataract. Previous analyses of outcomes by other groups have indicated generally good results, and we were interested in analyzing our outcomes.
Records of uveitic cataract surgery patients whose operation carried a procedure code indicating a complicated case were reviewed. Best-corrected visual acuities were recorded for all eyes at their immediate pre-op appointment and at day 1, week 1, month 1, month 3, month 6, year 1, and most recent visit. Not all eyes were examined at each of these time points. For purposes of mean visual acuity, counting fingers (CF) was documented as 20/2000 and hand motions (HM) was documented as 20/20000; all acuities were converted to logMAR. Visual acuity measurements of light perception (LP) or no light perception (NLP) had to be eliminated from averaging.
A total of 54 eyes of 42 uveitic patients underwent complicated cataract surgery by phacoemulsification with intraocular lens implantation at the Massachusetts Eye and Ear Infirmary during a period from 2006 through 2010; post-operative follow-up ranged from 23 days to 4 years, but 45 cases had at least 90 days of follow-up. Overall, mean BCVA improved from an average of 1.39 +/- 0.96 (~20/489) at the immediate pre-operative measurement to 0.66 +/- 0.88 (~20/90) at most recent measurement. This change was statistically significant (p<10-18) by a paired t-test. 38/54 eyes (70%) achieved at least a doubling of their visual angle. 32/54 eyes (59%) were administered intracameral triamcinolone at the conclusion of the case. The pre-op and post-op BCVA were similar between patients who did and did not receive triamcinolone. Of eleven eyes with documented inflammation less than three months prior to cataract extraction, none had a BCVA at one month post-op of 20/20 or better, whereas 13/42 (33%) eyes with no documented inflammation in the three months preceding their surgery had a BCVA of 20/20 or better at their month 1 appointment.
Most uveitic patients will gain visual acuity from cataract surgery; approximately 70% may be expected to double their visual angle. In patients with a relatively long duration of quiescent disease (3 months or more), a reasonable number may achieve 20/20 vision by one month post-operatively. These results support the conclusion that with appropriate management, patients may achieve excellent results.
This PDF is available to Subscribers Only