Phacoemulsification and Core Vitrectomy in Fuchs' Heterochromic Uveitis

Area of Science:

• Ophthalmology
• Uveitis Management
• Cataract Surgery Techniques

Background:

• Fuchs' heterochromic uveitis (FHU) can cause visually significant cataracts.
• Standard cataract surgery may be complicated by vitreous abnormalities in FHU patients.
• Effective surgical strategies are needed to manage FHU-associated cataracts.

Purpose of the Study:

• To evaluate the efficacy and safety of a combined surgical approach for cataracts in FHU.
• To assess visual outcomes and complications of phacoemulsification with posterior capsulorhexis, core vitrectomy, and ciliary sulcus IOL implantation in FHU.

Main Methods:

• Retrospective study of 18 eyes from 18 FHU patients undergoing cataract surgery.
• Procedure included phacoemulsification, posterior capsulorhexis, core vitrectomy, and PMMA IOL implantation in the ciliary sulcus.
• Patients selected based on intraoperative assessment of vitreous haziness (+2 or more).

Main Results:

• No intraoperative complications except minor iris bleeding in 7 eyes.
• No severe postoperative intraocular inflammation observed.
• All patients achieved logMAR visual acuity of 0.05 or better post-suture removal.
• Glaucoma developed in 2 patients; suture-induced astigmatism was a short-term issue.

Conclusions:

• Combined phacoemulsification, posterior capsulorhexis, core vitrectomy, and ciliary sulcus IOL implantation is safe for FHU cataracts.
• Removal of hazy vitreous contributes to good visual outcomes in FHU patients.
• This technique offers a viable surgical option for managing complex cataracts in FHU.