Cataract surgery in uveitis: a multicentre database study

• Published in: British journal of ophthalmology Vol. 101; no. 8; pp. 1132 - 1137
• Main Authors: Chu, Colin J, Dick, Andrew D, Johnston, Robert L, Yang, Yit C, Denniston, Alastair K
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.08.2017
• Subjects: Aged; Cataract - complications; Cataract - physiopathology; Cataract Extraction - methods; Cataracts; Diabetes; Diabetic retinopathy; Edema; Eye surgery; Female; Humans; Hypothesis testing; Intraoperative Complications - etiology; Intraoperative Complications - physiopathology; Male; Medical personnel; Ophthalmology; Postoperative Complications - etiology; Postoperative Complications - physiopathology; Treatment Outcome; Uveitis - complications; Uveitis - physiopathology; Vision Disorders - physiopathology; Vision Disorders - surgery; Visual Acuity - physiology; United Kingdom > UK; Lens and zonules; Inflammation; Treatment Surgery
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjophthalmol-2016-309047

Background/aimsCataract is an important source of visual loss in patients with uveitis. Whether or not outcomes of cataract surgery in eyes with uveitis are worse compared with non-uveitic eyes have to date been compromised by lack of reliable estimates of benefit and harm, which require data from large cohorts.MethodsElectronic medical record data were extracted from eight independent UK clinical sites for eyes undergoing cataract extraction between January 2010 and December 2014. 1173 eyes with a recorded diagnosis of uveitis were compared with a reference group of 95 573 eyes from the same dataset.ResultsUveitic eyes represented 1.2% of all eyes undergoing cataract surgery. Eyes in the uveitic group had worse preoperative visual acuity (0.87 vs 0.65 logarithm of the minimum angle of resolution (logMAR) units), were from younger patients and had shorter axial lengths and a higher incidence of ocular copathology including glaucoma. A greater number had documented small pupils, required additional surgical procedures, developed more intraoperative complications and had poorer postoperative visual acuity at all time points measured up to 6 months (0.41 vs 0.27 logMAR units at 12–24 weeks).ConclusionsThis large study cohort of eyes with a diagnosis of uveitis undergoing cataract surgery highlights more precisely the complex surgical demands, copathology and worse visual outcomes in this group. These data will allow more accurate preoperative counselling and planning. Although improvement in visual acuity is achieved in most cases, prognosis should be guarded, so that patient expectations are met. Compared with the non-uveitic population, the mean postoperative visual acuity is between one and two lines worse at all time points.