Surgical Management of Cataract with Anterior Uveitis

OBJECTIVE: To study the visual outcome, factors affecting visual recovery, complications encountered during cataract surgery in Anterior Uveitis. MATERIALS& METHODS: The present study was undertaken in the Department of Ophthalmology, Assam Medical College and Hospital (AMCH), Dibrugarh. The patients reporting to Out Patient Department (OPD) of Ophthalmology department were selected with prefixed criteria. The selected cases after proper preoperative examination and investigation, underwent Cataract Surgery in the Operation Theater (OT) of the department. RESULTS: A total of 28 eyes of 28 patients having cataract with anterior uveitis were operated. The male female ratio was 1: 1. In the present series, 25 cases (89.20 %) were of idiopathic type, while 1 case each was of Ankylosing spondylitis, Fuchs heterochromic iridocyclitis and juvenile Rheumatoid Arthritis. On 1st post-operative day, 9 cases (32.1 %) developed excessive anterior chamber reaction while the other 19 cases (67.9 %) had usual expected anterior chamber reactions. Recurrence of uveitis was most commonly seen in as many as 10 cases, while 8 cases had striate keratopathy, 4 cases developed hyphaema, 3 cases had raised IOP, 2 cases had corneal edema and 1 case of hypopyon 1st day after surgery. The best corrected visual acuity of 21 cases were in the range of 6/6 to 6/12, while 4 cases attained BCVA in the range of 6/18 to 6/36. The most common late post -operative complication seen on the 45th post- operative seen was pigments over the IOL surface, Posterior synechia was seen in 7 cases, PCO was noted in 5 cases, Vitreous Haze developed in 2 cases and cystoid macular edema was seen in only one case. CONCLUSION: With proper case selection, well planned meticulous surgery and good post-operative management surgical and visual outcome in these cases are quite satisfactory. Both ECCE and SICS with PCIOL implantation are safe procedures in properly selected cases of cataract with anterior uveitis and can give a predictably good visual result.