Abstract
Purpose :
To evaluate the long-term visual acuity (VA) outcome of cataract surgery in eyes with non-infectious scleritis and ocular cicatricial pemphigoid (OCP) and to assess prognostic factors associated with VA outcomes 20/40 or better, 12 months after cataract surgery.
Methods :
Multi-center retrospective cohort study.
A total of 170 eyes with noninfectious scleritis and 120 eyes with OCP that underwent cataract surgery while under tertiary uveitis management were included. Comparison cohort was 900 eyes with non-infectious anterior uveitis (NIAU). Standardized chart review was used to gather clinical data. Multivariable logistic regression models with adjustment for inter-eye correlations were performed to evaluate prognostic factors for VA better than 20/40 after a year.
Results :
Among 618 eyes (79 scleritis, 79 OCP, 460 NIAU) that completed one year follow up and pre-operative VA 20/50 or worse, 57 (72.2%) eyes with scleritis and 27 (34.2%) eyes with OCP were 20/40 or better after a year as compared to 281 (61.1%) eyes with NIAU. After adjusting for co-variates (such as age, gender, race, ethnicity, smoking, systemic autoimmune disease, use of oral or topical corticosteroid, location and inflammatory activity and VA preoperatively, type of cataract surgery and use of Intraocular lens); scompared to NIAU, scleritis eyes had similar odds of improvement to 20/40 or better (OR=1.28, 95% CI: 0.66- 2.51), but eyes with OCP had significantly worse odds (OR=0.27, 95%CI: 0.14 – 0.51), (overall p <0.001). Eyes with scleritis or OCP that improved to 20/40 or better immediately after surgery maintained the VA for 5 years postoperatively. Factors associated with good outcomes were age >18years, pre-operative VA 20/50 – 20/80 as compared to poorer VA, preoperative inactivity and use of intraocular lens.
Conclusions :
Our results suggest that adult eyes with noninfectious scleritis and OCP have improved visual acuity following cataract surgery and remain stable thereafter for at least 5 years. Anterior uveitis and scleritis have the highest success at improved VA post cataract surgery, as compared to OCP.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.