Delayed Hla-B27–Associated Uveitis Following Uncomplicated Phaco-Vitrectomy: A Case Report

Introduction: Postoperative inflammation after phaco-vitrectomy is usually mild, occurs early, and resolves with corticosteroid therapy. Delayed or recurrent uveitis after an initially uneventful course is uncommon and should prompt evaluation for non-infectious inflammatory causes, including underlying systemic disease.

The aim of this case report was to present delayed onset of postoperative, HLA-B27 related uveitis, followig uncomplicated phaco-vitrectomy.

This case presentation comes from the data collected in Ośrodek Chirurgii Oka Prof. Zagórskiego in Nowy Sącz, where Patient was diagnosed and treated.

Case Presentation: A 71-year-old man developed severe intraocular inflammation shortly after discontinuation of postoperative corticosteroids following uncomplicated phaco-vitrectomy. The early postoperative course was unremarkable. Repeated and detailed history taking revealed previously undisclosed ankylosing spondylitis with HLA-B27 positivity and a remote episode of iritis. The inflammatory flare was attributed to immune reactivation triggered by surgical stress and steroid withdrawal. Intensive topical and systemic corticosteroid therapy was required.

Conclusion: This case highlights the importance of thorough and repeated medical history assessment in patients with atypical postoperative inflammation. HLA-B27–associated disease should be considered in delayed uveitis following intraocular surgery, as early recognition may influence perioperative management and reduce the risk of recurrent, vision-threatening complications