Phacoemulsification with intraocular lens implantation in patients with uveitis

PURPOSE: To evaluate the outcomes of phacoemulsification with intraocular lens (IOL) implantation in eyes with uveitis. SETTING: Tertiary care center, Chandigarh, India. METHODS: Consecutive patients with uveitis and visually significant cataract were retrospectively studied for outcomes after phacoemulsification and implantation of a poly(methyl methacrylate) (PMMA) or a hydrophobic acrylic IOL. RESULTS: The study comprised 108 eyes of 81 patients (50 women, 31 men) with a mean age of 42.3 years +/- 13.98 (SD) (range 18 to 75 years) and a mean follow-up of 21.95 months (range 12 to 66 months). Etiology of uveitis was presumed tuberculosis (n = 24), Vogt Koyanagi Harada syndrome (n = 9), Behcet disease (n = 8), sarcoidosis (n = 5), ankylosing spondylitis (n = 4), serpiginous choroiditis (n = 2), and idiopathic (n = 29). The mean corrected distance visual acuity (CDVA) was 1.08 +/- 0.85 logMAR preoperatively and 0.42 +/- 0.78 D logMAR postoperatively; the improvement was statistically significant (P<.001, paired t test); Seventy-seven eyes (71.30%) achieved a CDVA between 0.00 log MAR and 0.30 logMAR (20/20 to 20/40 Snellen). Posterior capsule opacification (PCO) requiring neodymium:YAG capsulotomy occurred in 31 eyes (28.70%); posterior synechias in 27 eyes (25.00%); cystoid macular edema (CME) in 23 eyes (21.30%); recurrent uveitis in 6 eyes (5.55%); and epiretinal membrane formation, glaucoma, and iris bombe in 5 eyes (4.63%) each. CONCLUSIONS: Phacoemulsification with IOL implantation improved vision in most patients with coexisting cataract and uveitis. The main complications affecting visual outcomes were macular involvement, CME, PCO, and glaucoma.