Abstract
Purpose: :
To assess the postoperative inflammation and visual outcome after multifocal Intraocular lens implant (Crystalens) following cataract surgery in patients with chronic recurrent uveitis
Methods: :
Retrospective review of postoperative results in five patients (six eyes) with chronic recurrent uveitis who underwent cataract surgery with Crystalens implant. The preoperative mean visual acuity was 20/60. All patients were quiescent for two months prior to surgery and were treated with topical steroids and anti-inflammatory drops for one week prior to cataract extraction. All patients underwent uneventful surgery with placement of Crystalens in the capsular bag. Patients were followed at one day, one week, four weeks, six and twelve months.
Results: :
Our series included three females and two males with age ranging from 35 to 70 years. Three patients had idiopathic uveitis, one patient was HLA-B27 positive and had rheumatoid arthritis and the other patient had panuveitis with acute retinal necrosis (ARN) secondary to herpes zoster. The patient with ARN was previously treated with intravitreal Kenalog and avastin for chronic cystoid macular edema. On postop day one 5 eyes had 1-2+ cells with flare and patient with ARN had 3+ cells and flare. At week one the mean visual acuity was 20/25. At one week only the patient with ARN had persistent inflammation and developed cystoid macular edema at week three which was treated with intraocular kenalog. All patients maintained quiescence and excellent visual acuity at 12 months follow-up. There was no recurrence of inflammation in any of the patients.
Conclusions: :
Multifocal Intraocular lens such as Crystalens seem to be safe to use, well tolerated and with good results in patients with anterior uveitis, without any prolonged flare up of intraocular inflammation. Further studies with large series and longer follow-up is necessary to establish safety and long term outcome in uveitis patients.
Keywords: intraocular lens • uvea • inflammation