Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Uveitic cataracts are a major cause of vision loss in patients with chronic intraocular inflammatory disease. Surgical intervention of these cataracts is difficult as a result of the difficulties of persistent inflammation, timing of surgery and perioperative management. The purpose of this study is to assess the clinical and surgical determinants of postoperative visual results and complications in patients treated for cataracts associated with uveitis. The study was a Prospective observational case series of 123 uveitic cataract patients conducted at Department of Ophthalmology of Era’s Lucknow Medical College and Hospitals. Demographic and all the clinical and inflammation status data were collected. Details of the time of surgery, the technique employed, type of IOL used and the pre and postoperative steroid regimens were recorded. The patients were followed for 3 months after surgery in order to evaluate the visual acuity improvement and the rates of complications. Statistical analysis incorporated univariate and multivariate logistic regression for the estimation of the risk of visual improvement. The average age of patients was 42.5±14.3 years and anterior uveitis was the most frequent type (50.4%). Surgery was indicated in 66.7% of patients after minimum of 3 months of quiescence. The operative technique was phacoemulsification with foldable acrylic IOLs. At 3 months, 71.5% in the treatment groups gained 2 Snellen lines in ETDRS visual acuity. Independently, delayed surgery after adequate inflammation was a predictor of better vision (OR 2.8., 95% CI: 1.2‐6.5., p = 0.015). The main postoperative complications were cystoid macular edema in 14.6% of eyes and increased intraocular pressure in 12.2%. Modifying the timing of cataract surgery according to inflammatory quiescence markedly improves the visual prognosis in patients with uveitic cataract. Phacoemulsification using foldable acrylic IOLs plus personalized perioperative steroid therapy is safe and effective. Individualised surgical planning based on the inflammatory status is important to achieve optimal functional recovery and to avoid complications.
How to cite this article:
Anoop Mishra. Decision‐Making Factors Influencing Surgical Management and Visual Outcomes in Uveitic Cataracts: A Prospective Observational Study.
DOI: https://doi.org/10.36478/makrjms.2019.122.127
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2019.122.127