Cataract surgery in patients with Fuchs' heterochromic iridocyclitis

To evaluate the results of cataract extraction and posterior chamber intraocular lens (IOL) implantation in patients with Fuchs' heterochromic iridocyclitis (FHI).

We studied the records of 35 patients with FHI who underwent cataract extraction. Extracapsular cataract extraction (ECCE) was performed by phacoemulsification through a scleral flap in 9 patients and by manual delivery of the nucleus through a corneal section in 26 patients.

After a mean follow-up time of 24 (3-60) months, the visual acuity in 21 eyes (60%) was 20/20, and all eyes had 20/40 or better vision. Six eyes with implanted regular PMMA IOL developed a marked anterior uveitis, which was resolved within 3 weeks with topical steroids. Only 1+ or 2+ cellular reaction was observed postoperatively in patients with heparin-coated lens implantation and patients who underwent phacoemulsification. Biomicroscopic evidence of giant cell activity was observed in two patients with heparin-coated IOL and in 11 with regular PMMA IOLs after ECCE (two after phacoemulsification). Four eyes developed intraocular pressure elevation that reverts to normal within 24 weeks with medical therapy.

These results indicate that the surgical outcomes of FHI patients after cataract surgery appear to be better when the phacoemulsification technique is used or when heparin-coated lenses are implanted.