Intraocular lens removal patients with uveitis

PURPOSE: To report a series of patients with uveitis and cataract who had u ndergone cataract extraction with posterior chamber intraocular lens implan tation and who subsequently had the intraocular lens removed because of pro gressive intraocular damage from inflammation. METHODS: Review of the records of 19 patients after removal of a posterior chamber intraocular lens. The decision to perform surgery was based on stan dard criteria after evaluation at a single uveitis referral center. RESULTS: The complications leading to intraocular lens removal were perilen tal membrane (eight eyes), chronic low-grade inflammation not responding to antiinflammatory treatment (eight eyes), and cyclitic membrane resulting i n hypotony and maculopathy (three eyes). After intraocular lens removal the inflammation subsided and the visual acuity improved or stabilized in 14 o f the 19 eyes. The causes of further reduction in the visual acuity of the other five patients were macular edema (two patients), maculopathy resultin g from hypotony (one patient), retinal detachment (one patient), and vitreo us hemorrhage (one patient). CONCLUSIONS: Intraocular lens implantation can form part of a reasonable pl an for visual rehabilitation of patients with uveitic cataract, but inclusi on of an intraocular lens in the plan is not always in the overall long-ter m best interest of the patient, Intraocular lens removal may salvage useful vision for patients who continue to exhibit complications secondary to uve itis after cataract extraction and intraocular lens implantation, provided the intraocular lens is removed before irreparable damage has been done to macula or optic nerve. (Am J Ophthalmol 1999;128:31-37. (C) 1999 by Elsevie r Science Inc. All rights reserved.)