Abstract
Purpose: :
To evaluate the outcome of cataract and vitreous surgeries (alone or combined) performed in patients with uveitis.
Methods: :
The records of 424 patients with uveítis were reviwed to the"Clinica de Retina de Guadalajara" Jalisco, Mexico. Patients who required vitreous and /or cataract surgery were studied. All the patients had a complete ophthalmological exam and paraclinics exams or image exams in order to determinate the diagnosis of uveitis. Most of the patients were inactive at least 3 months before a surgical procedure. A total of 51 surgeries (48 patients) were performed.
Results: :
A total of 51 surgeries (48 patients) were performed. Twenty of 48 patients were male (42%) and 28 female (58%). Vitrectomy surgery was performed in 28 patients (55%); 10 patients (20%) underwent combined vitrectomy and lensectomy; 3 patients (5%) underwent phacovitrectomy with intraocular lens implant and 10 patients (20%) underwent phacoemulsification. The most frequent diagnosis in all the patients were as follows: ocular toxoplasmosis (8 patients); Vogt-Koyanagi-Harada disease (7 patients); Pars planitis (5 patients), and acute retinal necrosis (3 patients). Other diagnosis were as follows: idiophatic panuveitis, tuberculosis choroiditis, retinal idiophatic vasculitis, multifocal choroiditis and panuveitis, and Wegener's retinal vasculitis and vitreitis . In patients who underwent vitrectomy visual acuity (VA) improved 4 lines in 16 patients (57%); 7 patients improved 1 to 4 lines and 3 patients did not have improvement in their VA. In patients who underwent combined vitrectomy and lensectomy VA improved more than 4 lines in 3 (30%); 3 patients (30%) improved 1 to 4 lines, and 4 (40%) did not show improvement in their VA. Two patients (67%) who underwent phacovitrectomy their VA improved more than 4 lines, and 1 patient his VA improved 3 lines. The VA of all the patients who underwent phacoemulsification improved 1 to 4 lines. Secondary complications attribuible to surgical procedure were: macular oedema (50%); cataract (21%), and glaucoma (7%).
Conclusions: :
Vitrectomy surgery was performed most frequently in patients with uveitis. Toxoplasmosis, Vogt-Koyanagi-Harada disease and Pars planitis were the diagnosis in most of the patients whom underwent surgery. The majority of patients (82%) showed improvement in their VA when the surgery was performed under strict control of the inflammatory process.
Keywords: uvea • vitreoretinal surgery • cataract