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Aim of the study is to evaluate outcome of cataract surgery in different types of uveitis as regarding best corrected visual acuity (BCVA) and rate of post operative complications.
Cataract is the main cause of reversible blindness in patients with uveitis. Cataract occurs in up to 50% to 70% of patients with uveitis.
Preoperative complications, including anterior synechiae, posterior synechiae, and pupillary membrane formation, may increase surgical challenges. In addition, recurrent inflammation increases the incidence of postoperative complications and often affects the visual prognosis. In recent years, phacoemulsification with intra ocular lens (IOL)implantation has become the main surgical method for treating uveitis (complicated cataract), and the visual prognosis of patients who undergo this procedure is usually favorable.
Surgical treatment may be effective but is associated with higher rates of complication than in non uveitic eyes. Cystoid macular edema (CME) is the most common complication cataract surgery in the general population. Although, in most cases, the macular edema is self-limited, in rare cases it can lead to long-term visual deterioration that is difficult to treat.
Another common complication after cataract surgery is posterior capsule opacification (PCO) , leading to symptoms of glare or blurred vision, reduced visual acuity, or impaired posterior segment exam. Factors that are critical in the development of PCO include surgical technique, type of implanted intra ocular lens (IOL) either foldable hydrophilic acrylic, hydrophobic acrylic or silicone and postoperative control of uveitis
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Uncorrected and best corrected visual acuity | Other | Measuring of uncorrected and best corrected visual acuity after phaco emulsification and irrigation aspiration cataract surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cataract surgery | Procedure | cataract surgery in form of phaco emulsification or irrigation aspiration |
|
| Measure | Description | Time Frame |
|---|---|---|
| final postoperative uncorrected visual acuity (UCVA) | post operative uncorrected visual acuity which mean visual acuity without spectacle correction | 1 week post operative |
| final postoperative uncorrected visual acuity (UCVA) | post operative uncorrected visual acuity which mean visual acuity without spectacle correction | 1month post operative |
| final postoperative uncorrected visual acuity (UCVA) | post operative uncorrected visual acuity which mean visual acuity without spectacle correction | 3months post operative |
| final postoperative uncorrected visual acuity (UCVA) | post operative uncorrected visual acuity which mean visual acuity without spectacle correction | 6months post operative |
| Final post operative best corrected visual acuity (BCVA) | Post operative visual acuity with spectacle correction | 1 week post operative |
| Final post operative best corrected visual acuity (BCVA) | Post operative visual acuity with spectacle correction | 1month post operative |
| Final post operative best corrected visual acuity (BCVA) | Post operative visual acuity with spectacle correction | 3months post operative |
| Measure | Description | Time Frame |
|---|---|---|
| incidence of postoperative complications | cystoid macular edema which mean inflammation, swelling and collection of fluid inside macula) . | 6 months post operative |
| Reactivation of intraocular inflammation |
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Inclusion Criteria:
- Visually significant cataract ( means opacification of the crystalline lens adequate to interfere with vision)in patients with uveitis controlled for at least 1month.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mona Abdallah Abd AlRazik Ahmed, MD | Contact | 01014398129 | monaabdallah51290@aun.edu.eg | |
| Mohammed Gamal Saleh, lecturer | Contact | 01004530716 | mgsaleh05@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| Ashraf Khalaf Al Husseini, professor | Assiut University | Study Director |
| Wael Mohammed Ahmed Soliman, professor | Assiut University | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32157612 | Background | Carpentier SJ, Jung JL, Patnaik JL, Pecen PE, Palestine AG. A Cross-Sectional Online Survey Identifies Subspecialty Differences in the Management of Pediatric Cataracts Associated with Uveitis. Ophthalmol Ther. 2020 Jun;9(2):293-303. doi: 10.1007/s40123-020-00245-x. Epub 2020 Mar 10. | |
| 31788579 | Background |
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| ID | Term |
|---|---|
| D002386 | Cataract |
| D014605 | Uveitis |
| ID | Term |
|---|---|
| D007905 | Lens Diseases |
| D005128 | Eye Diseases |
| D014603 | Uveal Diseases |
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| ID | Term |
|---|---|
| D002387 | Cataract Extraction |
| ID | Term |
|---|---|
| D054140 | Refractive Surgical Procedures |
| D013508 | Ophthalmologic Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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| Final post operative best corrected visual acuity (BCVA) | Post operative visual acuity with spectacle correction | 6months post operative |
Appearance of inflammatory activity inside the eye after period of quiescence of at least 6 months
| 6 months post operative |
| Chen JL, Bhat P, Lobo-Chan AM. Perioperative Management of Uveitic Cataracts. Adv Ophthalmol Optom. 2019 Aug;4:325-339. doi: 10.1016/j.yaoo.2019.04.014. Epub 2019 May 18. |
| 30900580 | Background | Yangzes S, Seth NG, Singh R, Gupta PC, Jinagal J, Pandav SS, Gupta V, Gupta A, Ram J. Long-term outcomes of cataract surgery in children with uveitis. Indian J Ophthalmol. 2019 Apr;67(4):490-495. doi: 10.4103/ijo.IJO_846_18. |
| 30574896 | Background | Jinagal J, Gupta G, Agarwal A, Aggarwal K, Akella M, Gupta V, Suri D, Gupta A, Singh S, Ram J. Safety and efficacy of dexamethasone implant along with phacoemulsification and intraocular lens implantation in children with juvenile idiopathic arthritis associated uveitis. Indian J Ophthalmol. 2019 Jan;67(1):69-74. doi: 10.4103/ijo.IJO_713_18. |
| 30203671 | Background | El Gharbawy SA, Darwish EA, Abu Eleinen KG, Osman MH. Efficacy of addition of nepafenac 0.1% to steroid eye drops in prevention of post-phaco macular edema in high-risk eyes. Eur J Ophthalmol. 2019 Jul;29(4):453-457. doi: 10.1177/1120672118799626. Epub 2018 Sep 11. |