Study finds greater risk of cataract surgery complications in uveitis patients

NEW ZEALAND: According to a research reported in the American Journal of Ophthalmology, while the incidence of intraoperative complications following cataract surgery in eyes with uveitis continue to be low, managing postoperative care for patients who do suffer them remains difficult.

One of the most frequent visual impairment side effects of uveitis is cataract, which can cause up to 40% of the visual loss experienced by these patients. Uveitis patients require more complicated cataract surgery than senile individuals do. According to recent research, most situations can result in a useful aesthetic conclusion if they are addressed carefully.

The study aimed to ascertain the results of cataract surgery in eyes with uveitis, including the incidence of intraoperative and postoperative complications and indicators of visual outcomes.

For this purpose, the hazards associated with this type of condition prior to and following surgery were examined in participants from New Zealand. Retrospective observation was the goal of the study, which included 471 eyes from 371 participants. This observation period lasted for a lengthy 12 years (2008 to 2020). The outcome metrics comprised supplemental intraoperative interventions, intraoperative, postoperative sequelae, and postoperative visual outcomes and complications.

Key highlights of the research:

• Prior to cataract surgery, patients had a median uveitis duration of 3.0 years and a median interval of quiescence of 1.0 years.
• The two most typical additional procedures were reported to be vision blue (18.1%) and a posterior synechiae peel (32.3%).
• In 6.8% of the eyes, intraoperative complications occurred.
• By 12 months after surgery, 79.7% of patients had vision that was 20/50 or better, and the most frequent postoperative consequence was uveitis flare (56.5%).
• The researchers showed using Cox proportional-hazards analysis that quiescent time was linked to a lower chance of flare (hazard ratio, 0.794).
• 9.6% of eyes experienced postoperative CME, although the researchers were unable to find any reliable predictors of it in the multivariate study.

Given how quickly uveitis-related cataracts can develop, the researchers state that "earlier surgical intervention in uveitic cataracts has been proposed to reduce the greater surgical risk and challenges caused by advanced cataracts, as well as to avoid missing posterior segment disease activity and subsequent appropriate intervention," added the researchers.

The authors concluded that despite the low risk of intraoperative complications when the procedure is carried out by skilled surgeons, thorough postoperative monitoring for uveitis relapse and CME development is required because to the possibility of difficulties lasting longer than six months.

REFERENCE

Al-Ani HH, Sims JL, Niederer RL. Cataract surgery in uveitis: risk factors, outcomes and complications [published online ahead of print, 2022 Aug 21]. Am J Ophthalmol. 2022;S0002-9394(22)00314-2. doi:10.1016/j.ajo.2022.0