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Assessment of visual outcome after cataract surgery in patients with uveitis
N Okhravi1, S L Lightman, H M Towler
1Department of Ophthalmology, Moorfields Eye Hospital and the Institute of Ophthalmology, London, England, UK.
Objective:
To assess the outcome of cataract surgery in eyes of patients with uveitis.
Design:
Prospective, noncomparative case series.
Participants:
A total of 90 eyes of 76 patients fulfilled the enrollment criteria.
Intervention:
All patients had their surgery performed using standard cataract extraction techniques. Unless contraindicated, preoperative systemic steroids were administered to all patients with posterior disease, chronic anterior uveitis, with known macular edema, and those in whom outcome of cataract surgery on the fellow eye had been poor.
Results:
Patients were divided into those with anterior disease (n = 53) and those with posterior disease (n = 37). Overall, 81 (90%) of 90 eyes showed improvement in vision (median +4 Snellen lines). In those with anterior disease, the development of severe uveitis in the first week postsurgery was associated with a greater incidence of macular edema (P = 0.014). The single largest diagnosis in those with posterior disease was that of panuveitis (n = 24). This group showed the poorest visual outcomes in this study. The majority of patients, however, were noted to have visual loss secondary to conditions present before surgery.
Conclusion:
Cataract surgery in eyes with uveitis leads to an improvement of vision in the majority of cases. Severe postoperative uveitis is the most common postoperative complication and is associated with a significant risk of macular edema in those with anterior disease. In the posterior group, poor visual outcome after surgery is most commonly the result of preoperative vision-limiting conditions.
