Abstract
Purpose :
To identify and characterize patients with prolonged undifferentiated postoperative pseudophakic iridocyclitis (PUPPI) after uncomplicated phacoemulsification with posterior intraocular lens implantation (IOL).
Methods :
Single-center, consecutive retrospective chart review conducted at Wills Eye Hospital (Philadelphia, PA, USA) to identify all new patients with PUPPI referred to our uveitis specialist between January 2015 and December 2020. Documented demographic features included visual acuity, intraocular pressure, comorbidities such as macular edema, and examination findings for each clinic examination.
Results :
A total of 48 eyes of 30 patients were identified with PUPPI out of 1995 new patients (1.50%) during the study timeframe. Mean (SD) age was 68.8 (4) years. African-Americans and women were most commonly affected, making up 86% and 83% of the study population, respectively. Patients were followed for a mean of 10 months (range 0-54 months). The majority of patients remained on topical steroids for the entirety of their follow-up, including 84% of eyes at the 3-month visit, 75% at the 12-month visit, and 88% at the 24-month visit. The uveitis was suppressed in all patients by the 24-month visit when available. Mean visual acuity (MVA) was 20/50 at referral visit among patients with follow-up. There were no statistically distinct changes in MVA at subsequent visits. MVA was 20/36 at the 3-month visit (p=0.12), 20/36 at the 12-month visit (p=0.05), and 20/45 at the 24-month visit (p=0.70). Among patients with follow-up, cystoid macular edema was present in 20-30% of eyes throughout the study period (3-54 months). The MVA in eyes with CME was worse than in eyes without CME (20/66 versus 20/41, respectively) but the difference was not statistically significant (p=0.097).
Conclusions :
PUPPI is more common in African-Americans and more chronic in women. Patients may require prolonged courses of topical steroids after surgery with fair visual outcomes. Poorer visual outcomes may be related to presence of CME.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.