Intra operative, post operative complications and visual outcome in cases of post uveitic cataracts.

Abstract

INTRODUCTION: Cataract surgery in a patient with uveitis is more complex than senile cataract extraction, because it involves multiple considerations related to the cause of uveitis, prospects of visual rehabilitation, appropriate surgical timing, and technique, the type and material of intra ocular lens used. Establishing the diagnosis, thorough ocular examination, careful patient selection and meticulous control of perioperative inflammation are key elements to a successful visual outcome. AIM OF THE STUDY: 1. To assess intra operative and post operative complications encountered during surgery for uveitic cataract. 2. To assess the factors which affect the visual outcome. MATERIALS AND METHODS: The study was done in Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Egmore, Chennai from August 2005 to October 2007. The patients who attended the out patient and uvea clinic were included for the study. A total of 60 patients were taken up for the study. A detailed history and a complete ophthalmic examination was done. Inclusion criteria : 1. Patients with chronic uveitis and complicated cataract. 2. A quite eye (without inflammation) for atleast 3 months. Exclusion criteria : 1. Complicated cataract due to causes other than uveitis. 2. Patients with posterior segment pathology (by Bscan). RESULTS: The visual acuity after 6 wks ranged from 6/6 to 6/18 in 34 patients, 6/24 to 6/60 in 26 patients. The most common cause for decrease in vision was posterior capsular opacification. CONCLUSION: Cataract development is a very common occurrence in any form of anterior and intermediate uveitis, because of chronic intraocular inflammation, frequent relapses and long term use of corticosteroids. The reported incidence of cataract in uveitic patients is about 50% in juvenile rheumatoid arthritis and upto 75% in chronic anterior uveitis

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