EFFECT OF CATARACT-SURGERY WITH INTRAOCULAR-LENS IMPLANTATION ON INFLAMMATION IN CHRONIC UVEITIS - A LONGITUDINAL LASER FLARE PHOTOMETRY STUDY

Background: The precise effect of cataract surgery with implantation o f an intraocular lens (IOL) on the course of uveitis is not well known . Laser flare photometry allows quantitative assessment of intraocular inflammation. The aim of this study was to determine the effect of ca taract surgery with IOL implantation on the disease course and level o f inflammation in chronic uveitis, using laser flare photometry monito ring. Methods: The charts of all patients who underwent surgery for se condary uveitic cataract between 1990 and 1994 (24/558 [4.3%]) were re viewed. Only eyes that had received standardized perioperative steroid treatment and had systematic laser flare photometry follow-up were in cluded. Cataracts due to Fuchs' heterochromic cyclitis were excluded. Visual acuity, flare values and recurrence of flare episodes were comp ared before and after cataract surgery, and postoperative data were co mpared between eyes that received heparin-coated IOLs and those that r eceived uncoated IOLs. Results: Nineteen eyes of 16 patients met the i nclusion criteria. The mean length of the pre- and- postoperative foll ow-up periods was 779 and 444 days respectively. The mean visual acuit y increased from 0.2 (standard error of the mean [SEM] 0.2) preoperati vely to 0.8 (SEM 0.3) postoperatively (P less than or equal to 0.001). The mean flare value decreased from 58.6 (SEM 18.6) photons/ms during preoperative follow-up to 29.7 (SEM 7.8) photons/ms during postoperat ive follow-up (p less than or equal to 0.006). The mean number of recu rrences per 6 months decreased from 0.27 (SEM 0.03) preoperatively to 0.12 (SEM 0.01) postoperatively (P less than or equal to 0.05). The di fference in the postoperative recurrence rate between the eyes that re ceived coated IOLs (0.0) and those that received uncoated IOLs (0.18 [ SEM 0.02]) approached statistical significance (p less than or equal t o 0.054). Interpretation: Quantitative assessment of inflammation by l aser flare photometry in patients undergoing surgery for uveitic catar act showed that there was significantly less inflammation and fewer re currences postoperatively and that recurrences were less severe.