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J. Mauro, L. M. Cepeda, C. S. Foster; Multifocal IOL in Patients With Uveitis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1155.
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To evaluate the results after cataract extraction with phacoemulsification and implantation of a multifocal intraocular lens (IOL) in patients with a history of uveitis.
A retrospective descriptive case series was performed for all patients with a history of uveitis and cataract who underwent phacoemulsification with posterior chamber multifocal IOL (ReSTOR) implantation during the last two years at Massachusetts Eye Research & Surgery Institution (MERSI). The data recorded were age, gender, uveitic diagnosis, treatment modalities, preoperative quiescence time, final visual outcome (measures included uncorrected visual acuity (UCVA) for distance and near vision, complications, the need for additional therapy to obtain better visual acuity (YAG laser or spectacle use) and a questionnaire regarding their quality of life).
Twelve (12) eyes from six (6) patients (4 males and 2 females) aged 24 to 68 years old (mean 48.5) with a history of different forms of uveitis (anterior non-granulomatous uveitis, juvenile idiopathic arthritis related anterior iridocyclitis, idiopathic anterior uveitis, sarcoidosis associated uveitis and ankylosing spondylitis HLA-B27+ with psoriasis and associated anterior uveitis) underwent multifocal IOL implantation between September 2006 and September 2008. Follow up ranged from 5 to 22 (mean 14.5) months. At final follow-up 10 eyes (83.3%) had distance UCVA 20/25 or better, with 3 eyes achieving 20/20 and 7 eyes achieving 20/25 and 5 of 6 patients achieved J1 without spectacles. Intraoperative complications included cortex remaining in anterior chamber (n=1), requiring a second surgery (cortex removal). Postoperative complications included posterior capsule opacification (n=9), cystoid macular edema (n=3) and reactivation of inflammation (n=2). YAG laser was performed in 9 eyes and visual acuity improved after this procedure in all eyes. Postoperatively, only one patient required spectacles for near vision. No eyes developed glaucoma or retinal detachment. Overall, quality of life was rated to be improved after surgery for all patients.
Eyes with a history of uveitis, when well controlled or in remission, can have safe, effective, and favorable visual results following multifocal IOL implantation. Multifocal lens implant is not contraindicated in these patients and can result in improved quality of life.
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