Cataract and uveitis: Comparison of two different anti inflammatory protocols for the prevention of post-operative complications

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Abstract

Purpose

In the context of cataract surgery in patients followed for chronic uveitis, evaluate the effectiveness of a standart protocol corticosteroids versus a simplified protocol, by comparing the visual acuity and inflammation pre-and postoperatively in each two groups.

Methods

Prospective non-randomized single-center study was conducted in 2012, including 35 eyes(30 patients), mean age was 54.9 years. Patients were followed for chronic uveitis, whatever the cause, and were elligibles for a cataract surgery. 20 eyes received the standart protocol of corticosteroids, wich was oral corticosteroids combined pre-and postoperatively, as well as bolus injection of solumedrol and subconjunctival injection of dexamethasone in peroperative time. On the other side, 15 eyes received a lightweight protocol comprising only intraoperative corticosteroids (bolus and subconjunctival injection) without oral corticosteroids.

Results

With a median follow up of 6 months, after surgery, gain of visual acuity was significant in all patient. We lamented 4 earlier acute inflammatory relapses, 2 postoperative macular edema, 1 epimacular membrane and 1 retinal detachment. These complications did not link siginficatif with the choice of protocol, completeness or light. They were put in relation with the severity of previous inflammation, and particularly his etiology, preoperative inflammatory state, and if it was an antecedent of macular edema or not.

Conclusion

Simplified protocol can be proposed for cataract surgery in patient with chronic uveitis, especially for patients who did not relapse over a year and with no history of macular edema, as well as patients who were not found obvious systemic cause

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