Delayed HLA-B27-Associated Uveitis Following Uncomplicated Phacovitrectomy: A Case Report

Postoperative inflammation after phacovitrectomy is typically mild, occurs early, and resolves with corticosteroid therapy. Delayed or recurrent uveitis following an initially uneventful postoperative course is uncommon and should prompt evaluation for non-infectious inflammatory causes, including underlying systemic disease. A 71-year-old man developed severe intraocular inflammation shortly after discontinuation of postoperative corticosteroids following uncomplicated phacovitrectomy. The early postoperative course was unremarkable. Repeated and detailed history taking revealed previously undisclosed ankylosing spondylitis with HLA-B27 positivity and a remote episode of iritis. The inflammatory flare was attributed to immune reactivation triggered by surgical stress and steroid withdrawal, necessitating intensive topical and systemic corticosteroid therapy. This case highlights the importance of thorough and repeated medical history assessment in patients with atypical postoperative inflammation. HLA-B27-associated disease should be considered in cases of delayed uveitis following intraocular surgery, as early recognition may influence perioperative management and reduce the risk of recurrent, vision-threatening complications.