Devastating Result Of Cataract Surgery In Untreated Tubercular Uveitis Patients

To report case series of postoperative massive inflammation after cataract surgery in complicated cataract due to pan uveitis. After work up, the pan uveitis was presumed caused by Tuberculosis.

Case series of two patients, four eyes, at Jakarta, Indonesia.

This series report two cases of patient undergoing cataract surgery in complicated cataract due to chronic inflammation of the eye. At first visit, they came with blindness of one eye (ptisical eye). The visual acuity of the other eye was finger counting. The past cataract surgery was at the other clinic and the eye was massively inflamed afterward. These patients then got referred to our clinic. We’ve done several systemic investigations to these patients, including Mantoux test and chest Xray. Patients were highly positive ( 30-40 mm induration, hyperemic, and bullae) and one of the patient were positive with pulmonary tuberculosis. The patient got treated with ATT (anti-tuberculosis therapy) for nine months. After two months of therapy, we did cataract surgery of the fellow eye and injected triamcinolone acetonide intravitreally. The result was good, with final visual acuity of 0.8.

This case reports highlights the importance of evaluating the etiology the chronic inflammation before undergoing intraocular surgery. Intraocular inflammation can be the first manifestation of tuberculosis. Our case reports suggests that early diagnosis and specific treatment of tubercular uveitis can improve prognosis and visual outcome of the patients.