Inflammation after cataract extraction and intraocular lens implantation in patients with rheumatoid arthritis

The purpose of this study was to examine whether preoperative activity of rheumatoid arthritis influences the extent of anterior chamber inflammation after cataract extraction and intraocular lens implantation.

The medical records of 23 consecutive patients (33 eyes) with rheumatoid arthritis, who underwent cataract extraction with intraocular lens implantation, were reviewed during a 4 year period from April 1990 to March 1994.

Eleven patients who still showed a 1+ level of aqueous cells 1 month after the surgery had significantly higher titres of rheumatoid factor preoperatively, compared with the other 12 patients who showed no aqueous cells (p = 0.0019, Mann-Whitney U test). The persistence of aqueous cells also had a significant correlation with extracapsular cataract extraction compared with phacoemulsification (p = 0.0391, chi 2 test). Multivariate analysis showed that the titre of rheumatoid factor was the more significant element to determine the persistent aqueous inflammation. All the eyes, except for four which had a macular hole, optic disc atrophy, or retinitis pigmentosa gained visual acuity of 20/30 or better. The aqueous cells cleared 3 months after the surgery and left no complications in any of the eyes.

Intraocular lens implantation is basically a safe procedure for patients with rheumatoid arthritis, although postoperative aqueous inflammation tends to be persistent in patients with high titres of rheumatoid factor.