Phacoemulsification cataract extraction and posterior chamber lens implantation in patients with uveitis

PURPOSE: This study reports outcomes of phacoemulsification cataract extrac tion and posterior chamber intraocular lens implantation within the capsula r bag in patients with uveitis. METHODS: We retrospectively reviewed the charts of 32 patients (39 eyes) wi th uveitis who underwent phacoemulsification cataract extraction and poster ior chamber intraocular lens implantation by two surgeons at The Cleveland Clinic Foundation from January 1990 to June 1998. Patients with less than 3 months of follow-up were excluded. RESULTS: Diagnoses of uveitis included idiopathic (15 eyes), sarcoidosis (1 0 eyes), pars planitis (four eyes), cytomegalovirus retinitis (two eyes), F uchs heterochromic iridocyclitis (two eyes), syphilis (two eyes), and one e ye each of tuberculosis, Crohn disease, HLA-B27 associated, and acute retin al necrosis. Average follow-up was 20 months (range, 3 to 63 months). Best- corrected visual acuity improved in 37 eyes (95%). Average improvement was 4 +/- 3 Snellen acuity lines (range, 1 to 10 lines). Thirty-four eyes (87%) attained final visual acuity better than or equal to 20/40. Visual loss oc curred in one eye (3%) with cytomegalovirus retinitis. No improvement in vi sual acuity was seen in one eye (3%) that developed a retinal pigment epith elial detachment. Posterior capsule opacification occurred in 24 eyes (62%) , 12 of which required Nd:YAG capsulotomy (31%). Other postoperative compli cations included recurrence of uveitis (41%), cystoid macular edema (33%), epiretinal membrane formation (15%), and posterior synechiae (8%). CONCLUSIONS: Phacoemulsification cataract extraction with posterior chamber intraocular lens implantation is safe in patients with uveitis. The incide nces of recurrence of uveitis, cystoid macular edema, epiretinal membrane, and posterior synechiae were lower than those reported previously for extra capsular cataract extraction. (C) 2001 by Elsevier Science Inc. All rights reserved.).