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Maggie Wei, Parvathy Pillai, Philip H Scharper; Risk Factors and Outcome Measures Associated with Persistent Anterior Uveitis after Uncomplicated Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2068.
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Persistent anterior uveitis (PAU) can unexpectedly complicate recovery after routine phacoemulsification cataract surgery, especially in patients without histories of inflammatory diseases. Identifying risk factors for PAU will help clinicians manage patient expectations and explore prophylactic treatment protocols. The purpose of our study is to examine the risk factors and outcome measures associated with PAU.
We performed a retrospective, cohort study using 3 years of longitudinal data from a single center database (Oct 2016-Oct 2019). We included patients who underwent uncomplicated phacoemulsification cataract surgery and were followed for 3 months and longer. Patients with histories of uveitis or autoimmune diseases or who had cataract surgery combined with other intraocular surgeries were excluded. PAU was defined according to the Standardization of Uveitis Nomenclature Working Group. Factors including age, sex, race/ethnicity, intraocular pressures (IOP), best corrected visual acuity (VA) were studied using relative risk (RR), logistic regression, and the Fisher's exact test.
Out of the 23018 patients, 24 patients (13 right eyes, 11 left eyes) met the criteria for PAU, and were compared to 151 non-PAU patients (89 right eyes, 62 left eyes). 21/24 of the PAU patients (87.5%) were African American (RR=14.8, p=<0.0001), 2/24 (8.35%) were Asian (RR=34.5, p=0.007) and 1/24 (4.2%) were Caucasian. Age and sex differences were not associated with PAU. PAU and non-PAU patients had comparable IOP and VA outcomes at both the 3-month follow up and the last follow up visits (median follow up=11 months). Cystoid macular edema (CME) was found in 5/24 (22%) of PAU patients, all of whom were African American.
Our study demonstrates a higher risk of PAU in African Americans and Asians than has previously been reported (1). In addition, our study confirms the increased risk of CME in African American patients, emphasizing the importance of prophylactic treatment for CME in this group. The characteristics of PAU need to be solidified with multicenter and prospective studies, and further investigations will help us understand the role of iris pigmentation in the etiology and management of pro-inflammatory states.1 Reddy AK, et al. Risk factors associated with persistent anterior uveitis after cataract surgery. Am J Ophthalmol. 2019 Feb 19; Epub.
This is a 2020 ARVO Annual Meeting abstract.
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