Evaluation of foldable intraocular lenses in patients with uveitis

Objective: To evaluate various foldable posterior chamber intraocular lense s (IOLs) after phacoemulsification in patients with uveitis. Design: A prospective, noncomparative, interventional case series. Participants: Forty-nine consecutive patients (60 eyes) with various types of uveitis (anterior, n = 20; posterior, n = 1; panuveitis, n = 37, interme diate, n = 2). Interventions All patients underwent phacoemulsification with foldable post erior chamber IOL implantation. All eyes were free of active inflammation a t the time of surgery. A variety of IOL biomaterials were implanted: acryli c (n = 30), silicone (n = 17), and hydrogel (n = 13), Main Outcome Measures: Detailed examination was performed by one masked obs erver. Several parameters were compared for each implant biomaterial, inclu ding level of best corrected Snellen visual acuity at final follow-up, pres ence of posterior synechiae, anterior capsular phimosis, posterior capsule opacification, and the degree of cellular deposits on the IOL optic. Results: There were 26 males and 23 females, aged 9 to 83 years (mean, 48 y ears). Follow-up ranged from 1 to 33 months (mean, 17.03 months). At final follow-up, 56 eyes (93.3%) had an improvement in visual acuity compared wit h preoperative levels as follows: 34 eyes (56.6%) achieved an improvement o f four or more Snellen lines, and 44 eyes (73.3%) achieved 20/30 or better. Giant cells, observed on the IOL optic in 19 eyes (31.7%), were most often seen on the acrylic biomaterial at the 1-month follow-up, although this wa s not found to be statistically significant. Scratch marks produced by the lens-introducing forceps were seen in 24 eyes (40.0%), mainly on the acryli c and hydrogel optics. Posterior capsule opacification (PCO) occurred in 49 eyes (81.7%), with only 5 eyes requiring laser capsulotomy, There was no a ssociation between PCO and the various lens biomaterials, Other causes for reduced visual acuity included glaucomatous optic neuropathy (n = 5) and cy stoid macular edema (n = 8). Conclusions: The use of foldable IOLs in eyes with uveitis is safe, but the optimal biomaterial has yet to be found. (C) 2000 by the American Academy of Ophthalmology.