Document Detail

Cataract surgery in exudative uveitis: effectiveness of total lens removal, anterior vitrectomy, and scleral fixation of PC IOLs.
MedLine Citation:
PMID:  18320514     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Cataract surgery in exudative uveitis is often followed by severe complications (pupillary seclusion/occlusion, dense posterior capsule/anterior vitreous opacification, cystoid macular edema following repeat YAG laser procedures) which often drastically limit functional recovery. Total removal of cataract, anterior vitrectomy, and scleral fixation of a posterior chamber (PC) intraocular lens (IOL) has been tried as a surgical alternative, searching for lessened postsurgical complications and a better outcome. METHODS: Group A was a cohort of 12 patients with cataract after exudative (mostly sarcoidosis and Vogt-Koyanagi-Harada) uveitis, subjected to intracapsular cataract extraction, anterior vitrectomy, and scleral fixation of PC IOLs. Group B was the control group, including 12 patients with a similar clinical condition subjected to phacoemulsification or extracapsular cataract extraction plus in the- bag or in-the-sulcus IOL implantation. Follow-up time for both groups was at least 7 years. RESULTS: Postoperative inflammatory signs were substantially less in Group A patients, from 2 days up to >7 years postsurgery. Group A patients showed no cells/exudates adhering to the IOL surfaces, no synechiae, minimal (as compared to Group B) vitreous opacifications, and significantly higher visual acuity (p=0.024 at the seventh year control). Group A patients reported less frequent relapses of uveitis postsurgery, but the relevant clinical data did not allow statistical evaluations. CONCLUSIONS: Total removal of cataract in highly exudative uveitic eyes, plus anterior vitrectomy and scleral fixation of PC IOLs, although technically a more demanding surgical procedure, proved to be safe and more effective than classical procedures.
A G Secchi
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  European journal of ophthalmology     Volume:  18     ISSN:  1120-6721     ISO Abbreviation:  Eur J Ophthalmol     Publication Date:    2008 Mar-Apr
Date Detail:
Created Date:  2008-03-05     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110772     Medline TA:  Eur J Ophthalmol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  220-5     Citation Subset:  IM    
Department of Ophthalmology, University of Padova, Padova, Italy.
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MeSH Terms
Behcet Syndrome / complications
Cataract Extraction / methods*
Exudates and Transudates
Lens Implantation, Intraocular / methods*
Middle Aged
Postoperative Complications / prevention & control
Prospective Studies
Sarcoidosis / complications
Sclera / surgery*
Treatment Outcome
Uveitis / complications*
Uveomeningoencephalitic Syndrome / complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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