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M. Arino, D. Diaz-Valle, R. Mendez, R. Cuina, P. Arriola, N. Alejandre, J. Benitez-del-Castillo, E. Pato, J. Garcia-Sanchez; Outcome of Phacoemulsification Cataract Extraction in Patients With Uveitis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):374. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
This study reports the visual outcome of phacoemulsification and intraocular lens (IOL) implantation and some perioperative aspects in patients with severe uveitis
This is a retrospective review of medical records of 36 eyes (22 eyes with a diagnose of posterior uveitis) of 28 patients who underwent phacoemulsification cataract extraction and posterior chamber IOL implantation between 1999 and 2007. The preoperative treatment, surgical procedures, postoperative visual outcomes and complications were analyzed. Patiens with less than 6 months of follow-up were excluded.
Diagnoses of uveitis included idiopathic panuveitis (9 eyes), ocular tuberculosis (2 eyes), ocular sarcoidosis (2 eyes), multiple sclerosis (1 eye), intermediate uveitis (6 eyes), Behçet disease (2 eyes), lupus syndrome (2 eyes), Fuchs Heterochromic iridocyclitis (5 eyes), Idiopatic Anterior Uveitis (3 eyes), HLA B27+ anterior uveitis (4 eyes). Average follow-up was 58 months (range, 6 to 180 months). Best corrected visual acuity (BCVA) improved in 35 eyes (97%). Average improvement was 5,5 ± 3,4 Snellen acuity lines (range, o to 12 lines). Twenty-five eyes (67%) attained final visual acuity better than or equal to 20/40. No improvement in visual acuity was seen in one eye (3%) and visual loss didn't occurred in any eye. In 5 eyes (13%), relapse of intraocular inflammation occurred within 6 months after surgery. Other postoperative complications included posterior capsule opacification that required Nd: YAG capsulotomy in 16 eyes (44%), late recurrence of uveitis in 19 eyes (53%), cystoid macular edema in 6 eyes (16%), intraocular pressure elevation in 8 eyes (22%), and posterior synechiae in 6 eyes (16%).
The outcome of phacoemulsification cataract extraction and IOL implantation in patients with uveitis were satisfactory in terms of macular edema and uveitis recurrence. Identifying patients with higher risk of complications should help in patient counselling and to prevent these complications by using specific preoperative care.
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