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D. Gonzalez-Guajardo, M. Nuno, P. Munoz, M. Pedroza-Seres, Jr.; Outcome of Cataract and Vitreous Surgery in Patients With Uveitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5848.
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To evaluate the outcome of cataract and vitreous surgeries (alone or combined) performed in patients with uveitis.
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.
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%).
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.
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