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Results of cataract extraction in patients with heterochromic iridocyclitis-Fuchs

Poster Details

First Author: N.Micic SERBIA

Co Author(s):    G. Zlatanovic   M. Zivkovic   M. Zlatanovic   A. Miljkovic   V. Stojkovic  

Abstract Details



Purpose:

The purpose of this study was to evaluate the visual outcomes and complications of phacoemulsification (PE) and posterior chamber intraocular lens implantation (PC IOL) in patients with FUCHS heterochromic iridocyclitis.

Setting:

Center for eye disease Maja', Niš , Republic of Serbia

Methods:

Fuchs uveitis syndrome (FUS) or Fuchs heterochromic cyclitis is a chronic, non-granulomatous, anterior uveitis of insidious onset. It typically affects one eye of young adults in 90% cases. Most patients are diagnosed between 30-40 years of age, with equal male-female predominance. Heterochromia iridis, keratic precipitates and cataract are typical signs. Cataract is extremely common in about 80% cases in late stage of disease. It is usually posterior subcapsular. Secondary glaucoma is the most serious threat to vision. In the vast majority of cases, treatment with topical steroids produces no objective improvements. Mydriatic are unnecessary as posterior synechiae do not develop. Posterior sub-tenon injections of long-acting preparation such as triamcinolone acetonide may be beneficial for troublesome vitreus floaters. Vitrectomies in some cases are preferred too. The results of cataract surgery are usually good. In a period from 2003 till 2013 years, fifteen female and ten male patients (25 eyes), 12 to 40 years old (mean 34 years) with complicated cataract and FUS have been operated and followed. Preoperative therapy was: Sol Maxidex 6x1, Sol Uniklophen 2x1 and topical and systemic steroid for 7 days. PE with PC IOL was performed in all patients. We used hydrophobic acrylic IOL.

Results:

Preoperatively, the best corrected visual activity was in 5/60 patients, which improved 0.4 to 0.7 (16%) or better 0.8 to 1.0 (72%) after operation. Incipient cataract was diagnosed in eight patients and mature cataract in seventeen patients. Amsler's sign was present in two patients (8%) intraoperatively. Mild intraocular inflammation was also present after operation in 4 patients (16%). Late posterior capsular opacification was present in one patient (4%). Neodymium: YAG (Nd:YAG) laser capsulotomy has been performed six months after operation. Results of operation were none satisfying in one patient only with glaucoma and total excavation of disc n.optici.

Conclusions:

Phacoemulsification with posterior chamber intraocular lens implantation is effective and safe procedure in patients with Fuchs heterochromic iridocyclitis and cataract. It is method of choice in operative treatment with minimal complications and maximal visual outcomes. FINANCIAL INTEREST: NONE

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