Phacoemulsification with intraocular lens implantation in patients with uveitis

To investigate the safety and efficacy of phacoemulsification with intraocular lens implantation in eyes affected by uveitis.

A retrospective case series is presented including casenote review and update patient examinations. Patient data were withdrawn from the Uveitis Clinic database. All uveitis patients undergoing phacoemulsification with intraocular lens implantation from August 1995 to November 2000 were included. A pre-operative preparation protocol was used. Operative and post-operative complications, degree of postoperative inflammation, best-corrected and final visual acuity were the main outcome measures.

Eighty-six eyes of 75 patients underwent surgery, which in 11 cases was combined with trabeculectomy. Mean follow-up was 24.1 months. Eight eyes (10%) had severe or fibrinous uveitis post-operatively. The mean delay between surgery and return to baseline treatment was 8.6 weeks. Posterior capsule opacification occurred in 42% of eyes and Nd-YAG capsulotomy was required in 21%. Cystoid macular oedema was seen in 2 eyes. Seventy-two per cent of eyes retain a visual acuity of 6/9 or better, and 87% of eyes retain a post-operative improvement of 2 or more lines of Snellen acuity.

With careful patient selection, appropriate pre-operative preparation, diligent surgery and close post-operative supervision, phacoemulsification with intraocular lens implantation is safe and effective in the great majority of eyes with uveitis.