From the Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand.
From the Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand.
Am J Ophthalmol. 2022 Dec;244:117-124. doi: 10.1016/j.ajo.2022.08.014. Epub 2022 Aug 21.
To determine the outcomes of cataract surgery in eyes with uveitis, including the rates of intraoperative and postoperative complications, as well as predictors of visual outcomes.
Retrospective observational cohort study.
Setting: Tertiary public hospital setting in Auckland, New Zealand, between 2008 and 2020.
Patients who underwent cataract surgery following a diagnosis of uveitis.Main observation Procedures: Additional intraoperative procedures, intraoperative and postoperative complications, and postoperative visual outcomes and complications.
471 eyes of 371 subjects were included. Median duration of uveitis prior to cataract surgery was 3.0 years (interquartile range [IQR] 5.2) and median period of quiescence prior to surgery was 1.0 years (IQR 1.5). Additional procedures (posterior synechiae peel [32.3%] and vision blue [18.1%]) were common. Intraoperative complications occurred in 32 eyes (6.8%). Consultants were the primary surgeons in the majority (82.5%) of operations. By 12 months, visual acuity was 20/50 or better in 248 eyes (79.7%). The most common postoperative complication was uveitis flare, occurring in 56.5%. On Cox proportional hazards analysis, time quiescent was associated with reduced risk of flare (HR 0.794, P = .003). Postoperative cystoid macular edema (CME) developed in 45 eyes (9.6%), with no significant predictors identified on multivariate analysis.
Cataract surgery in uveitis is complex. In the hands of the surgically experienced, rates of intraoperative complications are low. The primary challenge is managing postoperative care as we report a high rate of uveitis relapse and CME. Careful monitoring is important as complications can be unpredictable and occur later than expected.
确定葡萄膜炎患者白内障手术的结果，包括术中及术后并发症的发生率，以及预测视力结果的因素。
回顾性观察性队列研究。
地点：新西兰奥克兰的一家三级公立医院，时间为 2008 年至 2020 年。
在诊断为葡萄膜炎后接受白内障手术的患者。主要观察程序：附加的术中程序、术中及术后并发症，以及术后视力结果和并发症。
共纳入 371 例患者的 471 只眼。白内障手术前葡萄膜炎的中位持续时间为 3.0 年（四分位距 [IQR] 5.2），手术前的静止期中位时间为 1.0 年（IQR 1.5）。常见附加手术（后粘连松解术 [32.3%] 和视觉蓝染术 [18.1%]）。32 只眼（6.8%）发生术中并发症。顾问是大多数（82.5%）手术的主要手术医生。在 12 个月时，248 只眼（79.7%）视力达到 20/50 或更好。最常见的术后并发症是葡萄膜炎发作，发生率为 56.5%。在 Cox 比例风险分析中，静止时间与降低发作风险相关（HR 0.794，P =.003）。45 只眼（9.6%）发生术后黄斑囊样水肿（CME），多变量分析未发现显著的预测因素。
葡萄膜炎患者的白内障手术较为复杂。在手术经验丰富的医生手中，术中并发症的发生率较低。主要挑战是管理术后护理，因为我们报告了较高的葡萄膜炎复发和 CME 发生率。由于并发症可能不可预测且比预期出现得晚，因此仔细监测很重要。
