The Risk of Intraocular Lens Complications in Uveitic Patients after Cataract Extraction with Intraocular Lens Implant

摘要

Purpose: To compare the rate of ocular complications in patients with uveitis versus patients without uveitis undergoing cataract extraction with posterior chamber intraocular lens (PCIOL). Methods: Through billing database for patients who had undergone complex cataract surgery from August 2001 to November 2013, we identified subjects who had active chronic inflammation due to noninfectious uveitis in the eye at the time of surgery. Subjects were divided into 2 groups; those who had PCIOL implant at the time of surgery (P) and those left aphakic intentionally (A). Statistical analysis of their rate of complications were performed. These results were compared to results in literature. Results: 331 charts were reviewed, and 27 subjects met study criteria and were reviewed in detail. 13 subjects were right eyes. Age ranged from 4 to 69, a mean age of 36 (SD = 21.25). 7 subjects were male. Among P, 9 of 14 patients had lens complication, 2 of whom had PCIOL removed. 7 of 14 had posterior capsular opacification (PCO) following surgery. 7 of 14 patients had pupillary membrane. 1 of 14 patients in P group had PCIOL dislocation. 6 of 14 of patients in P group required laser treatment for PCO. Among A, 8 of 13 patients had PCO following surgery. 2 of 13 patients in A group required laser treatment for PCO. There was no statistically significant difference between the rate of PCO in patients with or without uveitis. Also, there was no statistically significant difference between the rate of laser treatment in patients with or without uveitis. Conclusions: The rate of IOL associated complications appears to be much higher in patients with uveitis than in patients without uveitis after cataract surgery. In the literature, the PCO rate ranges from 20% to 40% while our rates were greater or equal to 50%. Furthermore, the placement of an IOL seems irrelevant in the formation of PCO as the rate of PCO in P groups vs. A group is not significantly different. The incidence of intraocular lens complications in cataract surgery in uveitis patients seems higher than in patients without uveitis.