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Kara C. LaMattina, Momoko Kimura; Racial and Ethnic Disparities in Rates of Rebound Iritis After Uncomplicated Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1674.
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The purpose of this study is to examine racial and ethnic disparities in the rate of rebound inflammation after uncomplicated cataract surgery. This study tested the hypothesis that patients of certain races or ethnicities are at higher risk of developing rebound iritis after uncomplicated cataract surgery.
This is retrospective review of patients over age 18 who underwent uncomplicated cataract extraction with intraocular lens (IOL) implantation at Boston Medical Center (BMC) between January 2012 and January 2019 who subsequently developed recurrence of inflammation upon standardized post-operative steroid taper. Exclusion criteria included a prior history of uveitis/trauma/intraocular surgery, concurrent intraocular procedures, subsequent diagnosis of uveitis, presence of retained lens fragments, evidence of infection, malposition of the IOL, and noncompliance with steroid taper or follow-up. Data collected included patient demographics, anterior chamber cell grade (according to the Standardization of Uveitis Nomenclature criteria), time from surgery to rebound iritis, time from rebound iritis to recovery, and number of recurrences of rebound iritis. Variables were compared amongst racial and ethnic groups using Fisher’s Exact Test.
A total of 11073 cataract surgeries were performed at BMC during this time frame; 63 cases of rebound iritis met inclusion/exclusion criteria. The rates of rebound iritis among different races and ethnicities were compared against a white non-Hispanic sample. African Americans had a 58% higher risk compared to white non-Hispanics (95% Cl=1.42-1.65; p=0.0001). Those who declined to answer had a 72% higher risk than compared to white non-Hispanics (95% Cl=1.71-1.96; p=0.0117). White Hispanics had a 348% higher risk than white non-Hispanics (95% Cl=1.90-4.38; p=0.0019). There was no statistical difference between races in anterior cell chamber, time from surgery to rebound iritis, recurrence of rebound iritis, and duration of steroid to recovery. However, there was a trend of African Americans requiring a longer course of steroids from time of rebound iritis to recovery.
African Americans and white Hispanics were shown to be at increased risk of rebound iritis compared to white non-Hispanic samples. Further study into optimal treatment regimens for different racial and ethnic groups could reduce these racial disparities in rebound iritis.
This is a 2020 ARVO Annual Meeting abstract.
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