Long-term effect of cataract phacoemulsification on the inflammation control and clinical outcome in uveitis patients .

IMPORTANCE: Cataract is one of the most common complications associated with uveitis, and is the leading cause of vision loss in these patients.

BACKGROUND: The study aimed to evaluate the effect of phacoemulsification on the long-term clinical outcome and inflammation control in uveitis patients.

DESIGN: Longitudinal study.

PARTICIPANTS: Of 1907 eyes with uveitis, 309 eyes underwent phacoemulsification were compared to a control group of 300 phakic eyes with uveitis.

METHOD: The risk of vision loss and macular oedema in pseudophakic eyes were compared to the phakic group. The rates of corticosteroids administration and uveitis relapse were also measured in pseudophakic eyes and compared to preoperative period.

MAIN OUTCOME MEASURES: Change in uveitis activity post phacoemulsification by measuring rate of uveitis relapse and use of topical and systemic steroids. Also, to measure the risk of vision loss and macular oedema post surgery.

RESULTS: Over a median follow-up time of 6.7 years or 2249 eye-years (EY), pseudophakic eyes had a greater risk of vision loss (hazard ratio [HR] 2.4, CI 1.4 to 4.0; P < 0.001) and macular oedema (HR 2.2, CI 1.4 to 3.4, P < 0.001) compared to the phakic uveitis group. Over 5 years post-surgery, the annual rate of uveitis relapses was less than the same period pre surgery (-1.2, 95% CI -2.0 to -0.2, P = 0.012) with no significant change in the annual rate of using topical and systemic prednisolone >7.5 mg/day.

CONCLUSIONS AND RELEVANCE: There was no significant increase in uveitis relapse rate post-phacoemulsification with the use of current prophylactic inflammation control measures.