SURGICAL-MANAGEMENT OF CATARACT AND POSTERIOR CHAMBER INTRAOCULAR-LENS IMPLANTATION IN FUCHS HETEROCHROMIC IRIDOCYCLITIS

Background: To determine the inflammatory course and level of visual r ehabilitation after cataract extraction and posterior chamber lens imp lantation in patients with Fuchs' heterochromic iridocyclitis complica ted by cataract. Methods: In a clinical trial, 32 eyes (visual acuity of 20/160 or worse) of 30 patients underwent extracapsular cataract ex traction (19 eyes) or lensectomy (13 eyes) accompanied by posterior ch amber intraocular lens implantation. Indirect ophthalmoscopy was perfo rmed intraoperatively prior to intraocular lens implantation and the e xtent of vitreous haze was assessed. If vitreous haziness was 3+ or mo re, core vitrectomy (two eyes) or three-port pars plana deep vitrectom y (four eyes) was performed. Results: After an average follow up of 14 .4 months (6 to 24 months), there was no statistically significant inc rease in cell and flare in the anterior chamber and vitreous or in ker atic precipitates compared with the preoperative status of the eyes. H owever, 12% of the eyes developed synechiae (anterior and/or posterior ) in comparison to preoperative condition (p < 0.05). Eighty-seven per cent of the eyes gained visual acuity of 20/40 or better (P < 0.005). Using the logistic regression model, a higher level of preoperative in flammation was associated with reduced likelihood of gaining visual ac uity of 20/25 or more (OR = 0.25, 95% CI 0.049, 1.255). The complicati ons of surgery were synechiae, 12%; opaque posterior capsule, 12%; vit reous loss, 3%; chronic glaucoma, 3%; and retinal detachment, 3%. Conc lusions: Implantation of a posterior chamber intraocular lens can be w ell tolerated in patients with Fuchs' heterochromic iridocyclitis. Vit rectomy, whenever indicated in addition to cataract extraction, improv es visual rehabilitation.