Abstract
Abstract: :
Purpose: To report the outcomes of phacoemulsification and pars–plana vitrectomy(PPV) as a combined procedure to restore visual acuity in patients with cataract and posterior segment involvement secondary to chronic uveitis. Methods: 36 eyes of 34 patients (20 women and 14 men) with posterior segment involvement secondary to chronic uveitis, undergoing a combined procedure from 1998 to 2002 at the Massachusetts Eye and Ear Infirmary. The main outcome measures were visual acuity, intraocular pressure, cystoid macular edema (CME). Results:The mean patient age was 45 ± 16.09 years. The mean duration of uveitis prior to surgery was 56 ± 44.17 months. In 24 cases (66.7%) an intraocular lens (IOL) was implanted during the surgery; the remaining 12 cases (33.3%) were left aphakic. Five eyes (13.8%), received an intraocular steroid injection intraoperatively. Visual acuity improved in 26 cases (72.2%), deteriorated in 5 cases (13.9%) and remained unchanged in 5 cases (13.9%). The main reason for the visual acuity degradation was refractory macular edema. During the follow–up, 2 IOL’s were explanted secondary to lens intolerance. One IOL was repositioned because of iris capture by haptics; one IOL was dislocated inferiorly causing monocular diplopia. The mean follow–up period was 23.4 ± 16.7 months Conclusions:Combined phacoemulsification and PPV is a feasible technique for the removal of cataract and pathologic vitreous in eyes with chronic uveitis. Although the exact role of vitrectomy in patients with uveitis remains to be determined, the combination of PPV and cataract surgery can successfully restore useful vision in the majority of cases.
Keywords: cataract • vitreous • treatment outcomes of cataract surgery