Abstract
Purpose :
Prior literature has reported that approximately 93% of eyes undergoing cataract surgery achieve a postoperative spherical equivalent (SE) within 1 Diopter (D) of that predicted by preoperative biometry (Lundstrom et al, 2018). While prior studies have assessed vision outcomes and postoperative complications following cataract surgery in patients with uveitis, less is known about refractive outcomes in this population. Our study assessed the refractive outcomes following uveitic cataract surgery and factors associated with deviations from the target refractive goal.
Methods :
A multi-center retrospective chart review of patients with a history of uveitis undergoing cataract extraction was performed between June 2015 and June 2020. Subject demographics, ocular history, pre and postoperative examination findings, and biometry measurements were obtained. The difference between the refractive target and postoperative refractive SE was determined. We tested for association between a postoperative deviation from target greater than 1 D and several factors including age at the time of surgery, location of uveitis, presence of preoperative keratic precipitates or posterior synechiae, history of cystoid macular edema, preoperative logMAR acuity, and persistent inflammation one month postoperatively using t-tests or chi-square tests.
Results :
We examined two hundred eighty-three eyes from 216 subjects. 40.6% of subjects had a refractive outcome which deviated more than 0.5 D from the refractive goal, and 13.4% of subjects deviated more than 1 D from the refractive target. The mean difference from refractive goal was 0.57 ± 0.68 D (range 0 – 4.54 D). The mean preoperative logMAR acuity for eyes >1 D from refractive goal was 0.21 greater than eyes < 1 D (p=0.008). Average age at time of cataract surgery was less for eyes >1 D from their refractive target (51.6 vs 59.0 years, p=0.014). The presence of preoperative keratic precipitates was also associated with a refractive outcome >1 D from the planned target (p<0.001).
Conclusions :
A notable portion of eyes undergoing uveitic cataract surgery deviated from the planned refractive target by at least 1 D. Poorer preoperative acuity, younger age at the time of surgery and preoperative keratic precipitates were associated with this outcome.
This is a 2021 ARVO Annual Meeting abstract.