Results of extracapsular cataract extraction with intraocular lens implantation in eyes with uveitis and Fuchs' heterochromic iridocyclitis.

A total of 63 cataractous eyes of 48 patients (group 1) with uveitis and 12 eyes of 12 patients (group 2) with Fuchs' heterochromic iridocyclitis underwent extracapsular cataract extraction (ECCE) with capsular bag fixation of a posterior-chamber intraocular lens (PC OIL). A perioperative regimen of systemic dexamethasone (0.8-1.5 mg/kg) was initiated. This dose was tapered by 20 mg/day, reaching zero within 4-8 days. Intraoperatively, synechiolysis was required in 51 of 63 eyes in group 1 and a sector iridectomy was necessary in 42 eyes. A fibrinous reaction occurred in 7 eyes. During a mean follow-up period of 2 years, 7 eyes developed uveitis recurrences that were successfully treated with topical and systemic steroids in 4 eyes; the other 3 eyes developed cystoid macular edema. Overall, mean visual acuity improved from 20/120 to 20/50. Intraoperatively, 3 patients in group 2 developed a transient hemorrhage from atypical anterior-chamber-angle vessels. Postoperatively, 3 eyes showed a transient fibrinous reaction. The mean visual acuity improved from 20/240 to 20/30. In patients with Fuchs' heterochromic iridocyclitis, ECCE with PC IOL implantation renders good intermediate results. In other selected patients with uveitis, in-the-bag IOL implantation may be performed with an acceptable risk. As judged from their improved visual acuity, 57 of 63 eyes (90.5%) benefited from the procedure.