Phacoemulsification with primary implantation of an intraocular lens in patients with uveitis

Figures & data

Table 1 Characteristics of patients with and without uveitis undergoing cataract surgery

Parameter	Uveitis (n=58)	No uveitis (n=225)	P-value
Sex, n (%)
Female	35 (60.3)	135 (60.0)	1.00a
Male	23 (39.7)	90 (40.0)
Age at surgery, years
Mean (SD)	61.4 (15.6)	69.1 (13.5)	<0.001b
Median (range)	60.5 (30–90)	70.0 (27–93)	0.001c
Cataract subtype, n (%)	(n=58)	(n=217)
Cortical	1 (1.7)	12 (5.5)	0.31a
Posterior subcapsular	18 (31.0)	14 (6.5)	<0.001a
Nuclear	16 (27.6)	89 (41.0)	0.07a
Mixed	17 (29.3)	92 (42.4)	0.10a
Dense	6 (10.3)	10 (4.6)	0.11a

Note:

a Fisher’s exact test;

b Student’s t-test;

c Mann–Whitney U test.

Abbreviation: SD, standard deviation.

Table 2 Uveitis etiology/associated rheumatic disease and anatomical location

Systemic and/or ocular diagnosis	n (%)
Behçet’s disease	1 (1.7)
Fuchs’ heterochromic uveitis	12 (20.7)
Herpes-related uveitis	3 (5.2)
HLA-B27-related uveitis	2 (3.4)
Idiopathic anterior uveitis	16 (27.6)
Idiopathic vasculitis	1 (1.7)
Morbus Bechterew	6 (10.3)
Polymyalgia/temporalis arteritis	1 (1.7)
Possner Schlossman	1 (1.7)
Psoriatic arthritis	2 (3.4)
Sarcoidosis	7 (12.1)
SLE	1 (1.7)
Toxoplasmosis	2 (3.4)
Ulcerous colitis	1 (1.7)
Wegener’s granulomatosis	2 (3.4)
Anatomical localizationa	n (%)
Anterior	56 (96.6)
Intermediate	2 (3.4)
Posterior	4 (6.9)
Pan	0

Notes:

a Some eyes had more than one type of uveitis localization; in one eye, uveitis was mainly posterior. The other eyes with posterior and intermediate uveitis also had anterior uveitis.

Abbreviations: SLE, systemic lupus erythematosus; HLA, human leukocyte antigen.

Table 3 Visual outcome, ocular comorbidity and complications at 4 weeks and 6 months after cataract surgery

Parameter	Uveitis	No uveitis	P-value
BCVA, logMAR, mean ± SD
Preoperatively	0.63±0.52	0.61±0.53	0.79c
4 weeks	0.12±0.18	0.21±0.37	0.10c
6 months	0.21±0.29	0.30±0.54	0.42c
BCVA, decimal, median (range)
Preoperatively	0.30 (0.00–0.80)	0.40 (0.00–1.30)	0.57b
4 weeks	0.80 (0.16–1.30)	0.80 (0.00–1.30)	0.08b
6 months	0.80 (0.04–1.30)	0.70 (0.00–1.30)	0.67b
BCVA, decimal, n (%)
Preoperatively
≥0.5	19 (34.5)	81 (36.5)	0.88a
4 weeks
≥0.5	48 (87.3)	180 (86.1)	1.00a
6 months
≥0.5	25 (69.4)	27 (77.1)	0.59a
CME, n (%)
Preoperatively	1 (1.7)	0	0.22a
4 weeks	1 (1.8)	2 (1.0)	0.53a
6 months	0	0
Glaucoma treatment, n (%)
Preoperatively	7 (12.1)	20 (8.9)	0.46a
4 weeks	10 (17.9)	20 (9.1)	0.09a
6 months	7 (17.9)	10 (13.7)	0.59a
PCO, n (%)	11 (19.0)	28 (12.4)	0.20a

Note:

a Fisher’s exact test;

b Mann–Whitney U test;

c Student’s t-test for unpaired groups.

Abbreviations: BCVA, best corrected visual acuity; CME, cystoid macular edema; PCO, posterior capsule opacification.

Table 4 Intraoperative difficulties and complications

Parameter	Uveitis	No uveitis	P-value
Intraoperative difficulties, n (%)
Mechanical pupil dilation	9 (15.5)	12 (5.4)	0.02a
Capsular dye	1 (1.7)	10 (4.4)	0.47a
Hooks in rhexis	0	1 (0.4)	1.00a
Capsular tension ring	2 (3.3)	40 (17.8)	0.004a
Totalb	12 (20.7)	54 (24)	0.73a
Intraoperative complications, n (%)
Posterior capsular tear	0	2 (0.9)	1.00a

Notes:

a Fisher’s exact test;

b including mechanical pupil dilation, use of capsular dye, iris hooks in rhexis or capsular tension ring.

Table 5 Hydrophobic and hydrophilic intraocular lenses and PCO in patients with and without uveitis

IOL-type, n (%)	Uveitis	No uveitis	P-value
Hydrophobic	55 (94.8)	199 (91.7)	0.58a
Hydrophilic	3 (5.2)	18 (8.3)	–
PCO, n (%)	Hydrophobic	Hydrophilic
Yes	37 (14.6)	2 (9.5)	0.75a
No	217 (85.4)	19 (90.5)	–

Notes: Median follow-up time for patients with uveitis was 54.3 months (range, 0.2–108.9 months) and for patients without uveitis was 5.1 months (range, 0.2–104 months).

a Fisher’s exact test.

Abbreviations: IOL, intraocular lens; PCO, posterior capsule opacification.

Table 6 Outcome and complications reported after phacoemulsification in patients with anterior uveitis

Study (year of publication)	Studied eyes, n (patients)	Average agea, years ± SD (range)	Average follow-up, months ± SD (range)	Anterior uveitis, n (%)	Average BCVA preop logMAR ± SD (range)	Average BCVA postopb logMAR ± SD (range)	CME preop, n (%)	CME postop, n (%)	Nd:YAG, n (%)
Present study	58 (58)	61.4±15.6	54.3 (0.2–109)	56 (97)	0.63±0.52	0.21±0.29	1 (2)	1 (2)	11 (19)
Abbouda et al (2016)^Citation9	59 (46)	61.4±18.2	42.1±55.8	33 (56)	0.49±0.42	0.20±0.31	0 (0)c	6 (10)d	15 (25)
Tomlins et al (2014)^Citation11	171 (140)	51.0 (16–85)	45.6 (11–124)	67 (39)	–	71% ≥0.50 (decimal)	34 (20)	18 (11)	31 (18)
Kosker et al (2013)^Citation5	55 (48)	44.9±15.6	6e	55 (100)	–	95% ≥0.50 (decimal)	21 (38)	7 (13)	2 (4)
Suelves et al (2012)^Citation2	18 (16)	58.7±15.5	53.7±20.4	6 (33)	0.51±0.27	0.27±0.79	–	9 (50)	13 (72)
Ram et al (2010)^Citation17	108 (81)	42.3±14.0	22.0 (12–66)	39 (48)	1.08±0.85	0.42±0.78	–	23 (21)	31 (29)
Elgohary et al (2007)^Citation18	101 (101)	52.8±15.6	23.4 (3–80)	57 (56)	1.15f	0.40f	4 (19)	21 (21)	33 (33)
Kawaguchi et al (2007)^Citation7	131 (95)	61.7 (30–87)	57 (12–168)	–	1.05 (0.10–3.00)	0.29 (−0.18 to 2.00)	0 (0)	8 (6)	31 (24)
Suresh and Jones (2001)^Citation13	86 (75)	43.8 (19–89)	24.1 (4–63)	61 (71)	–	84% ≥0.50 (decimal)	12 (14)	2 (2)	18 (21)
Estafanous et al (2001)^Citation4	39 (32)	50.2±13.4	20 (3–63)	12 (31)	0.54 (0.18–1.82)	0.18 (−0.12 to 3.00)	12 (31)	13 (33)	12 (31)

Notes:

a Age at surgery;

b last follow-up;

c patients with history of CME were excluded;

d one eye had diffuse macular edema;

e all patients were followed for 6 months; standard deviation or range not given;

f mean from figure, SD or range not given.

Abbreviations: BCVA, best corrected visual acuity; CME, cystoid macular edema; IOL, intraocular lens; logMAR, logarithm of the minimum angle of resolution; Nd:YAG, neodymium YAG capsulotomy; PCO, posterior capsule opacification; preop, preoperative; postop, postoperative; SD, standard deviation.

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