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Long term follow-up of patients with persistent anterior uveitis after uncomplicated cataract surgery
Elyssa Dionne
Presenter:
Elyssa Dionne BA, Injy El-Dib BS, Leena Surapaneni BA, Patrick J Hunt MD PhD, Michael King Wong MD, Brian DeBroff MD, Ninani Kombo MD
Authors:
Affiliation:
none
Purpose
To describe the clinical course of patients with persistent anterior uveitis (PAU) after uncomplicated cataract surgery
Methods
This is a retrospective case series of 50 eyes from 40 patients that developed PAU following uncomplicated cataract surgery. PAU is defined as anterior chamber cell grade ≥ 0.5 according to the Standardization of Uveitis Nomenclature system, requiring topical steroid treatment more than two months after cataract surgery.
Thorough chart review was performed and data from demographic, surgical, clinical, management information, and lab results were collected. Data for each patient were recorded throughout treatment to determine clinical remission (i.e. absence of inflammation for >3 months).
Results
Systemic workup did not uncover any common systemic causes of anterior uveitis in 100% of the patients. One patient, treated for syphilis treated 40 years prior had a positive FTA-ABS with negative RPR . Of the 50 eyes, 32 (64%) had resolution within 3 months of steroid use after resumption of post-operative steroids. Average duration of steroid use after the standard course of post-operative drops was 2 months. 46 eyes (92%) were quiescent at 12 months after resolution. 2 eyes (4%) were lost to follow-up after resolution. The remaining 4% were on long-term steroids past the duration of the study. Patients treated longer than 9 months were less likely to achieve remission (Figure 1). Only one patient had a decline in visual acuity greater than one line on the Snellen chart from post cataract surgery to post recovery from PAU. Of the 17 eyes with preexisting glaucoma, only one required additional IOP lowering treatment. 12 (24%) eyes developed cystoid macular edema (CME). None required immunomodulatory therapy for the treatment of PAU. (Table 1).
Conclusion
In most patients, PAU is successfully treated with steroids drops with complete resolution within 3 months. Treatment does not negatively affect visual acuity. The most common complications were macular edema and prolonged steroid use. The probability of achieving remission decreases as treatment duration increases.
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