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Outcome of phacoemulsification in patients with uveitis

Identifieur interne : 005B73 ( Main/Merge ); précédent : 005B72; suivant : 005B74

Outcome of phacoemulsification in patients with uveitis

Auteurs : M. A. Elgohary [Royaume-Uni, Égypte] ; P. J. Mccluskey [Australie] ; H. M. A. Towler [Royaume-Uni] ; N. Okhravi [Royaume-Uni] ; R. P. Singh [Australie] ; R. Obikpo [Royaume-Uni] ; S. S. Lightman [Royaume-Uni]

Source :

British journal of ophthalmology [ 0007-1161 ] ; 2007.

RBID : Pascal:07-0303695

Descripteurs français

Pascal (Inist)
- Uvéite, Pronostic, Evolution, Phacoémulsification, Chirurgie, Homme, Ophtalmologie, Traitement.
Wicri :
- topic : Chirurgie, Homme.

English descriptors

KwdEn :
- Evolution, Human, Ophthalmology, Phacoemulsification, Prognosis, Surgery, Treatment, Uveitis.

Abstract

Aims: To examine the visual outcome and identify risk factors for postoperative uveitis, macular oedema and neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy after phacoemulsification and intraocular lens (IOL) implantation in patients with uveitis. Method: This is a retrospective review of the medical records of 101 eyes of 101 patients. One eye was randomly selected for inclusion in patients who had bilateral surgery. Patients with juvenile arthritis, keratouveitis and lymphoma-associated uveitis were excluded. Results: At the first postoperative and final visits, visual acuity was significantly better (p<0.001), and 64.4% and 71.3% of patients, respectively, had achieved ≥2 Snellen's lines of visual improvement. The cumulative probability of doubling of the visual angle was 52% over 6 years of follow-up, and this occurred at a higher rate in the presence of preoperative retinal or optic nerve lesions (HR (95% Cl) 4.49 (1.41 to 14.29)). Within 3 months after operation, uveitis was more likely to develop in female patients (OR (95% Cl) 6.21 (1.41 to 27.43)) and in the presence of significant intraoperative posterior synechiae (OR (95% Cl) 8.43 (1.09 to 65.41)); macular oedema was more likely to develop in patients who developed postoperative uveitis (OR (95% Cl) 7.45 (1.63 to 34.16)). Nd:YAG capsulotomy occurred at a higher rate in patients aged ≤5 years (HR (95% Cl) 2.28 (1.06, 4.93)) and in those with hydrogel lOLs (HR (95% Cl) 3.71 (1.04 to 13.20)), and occurred at a lower rate in patients who had prophylactic systemic corticosteroids (HR (95% Cl) 0.25 (0.11 to 0.59)), with plate-haptic silicone lOLs (HR (95% Cl) 0.23 (0.08 to 0.64)) and three-piece silicone lOLs (HR (95% Cl) 0.19 (0.05 to 0.74)) in comparison to those with polymethylmethacrylate lOLs. Conclusion: Most patients with uveitis achieve improved visual acuity after phacoemulsification, but an increasing rate of visual loss is observed in those with pre-existent macular or optic nerve lesions. Identifying patients who are at risk of postoperative complications should help in patient counselling and to pre-empt these complications by using preoperative prophylactic corticosteroids, careful IOL selection and postoperative intensive corticosteroids.

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Pascal:07-0303695

Le document en format XML

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<author><name sortKey="Lightman, S S" sort="Lightman, S S" uniqKey="Lightman S" first="S. S." last="Lightman">S. S. Lightman</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Outcome of phacoemulsification in patients with uveitis</title>
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<author><name sortKey="Okhravi, N" sort="Okhravi, N" uniqKey="Okhravi N" first="N." last="Okhravi">N. Okhravi</name>
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<author><name sortKey="Singh, R P" sort="Singh, R P" uniqKey="Singh R" first="R. P." last="Singh">R. P. Singh</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Royal Prince Alfred Hospital</s1>
<s2>Sydney, New South Wales</s2>
<s3>AUS</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>Australie</country>
<wicri:noRegion>Royal Prince Alfred Hospital</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Obikpo, R" sort="Obikpo, R" uniqKey="Obikpo R" first="R." last="Obikpo">R. Obikpo</name>
<affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Whipps Cross University Hospital</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lightman, S S" sort="Lightman, S S" uniqKey="Lightman S" first="S. S." last="Lightman">S. S. Lightman</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Moortields Eye Hospital</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>1 aut.</sZ>
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<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
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<series><title level="j" type="main">British journal of ophthalmology</title>
<title level="j" type="abbreviated">Br. j. ophthalmol.</title>
<idno type="ISSN">0007-1161</idno>
<imprint><date when="2007">2007</date>
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<seriesStmt><title level="j" type="main">British journal of ophthalmology</title>
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</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Evolution</term>
<term>Human</term>
<term>Ophthalmology</term>
<term>Phacoemulsification</term>
<term>Prognosis</term>
<term>Surgery</term>
<term>Treatment</term>
<term>Uveitis</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Uvéite</term>
<term>Pronostic</term>
<term>Evolution</term>
<term>Phacoémulsification</term>
<term>Chirurgie</term>
<term>Homme</term>
<term>Ophtalmologie</term>
<term>Traitement</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term>
<term>Homme</term>
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<front><div type="abstract" xml:lang="en">Aims: To examine the visual outcome and identify risk factors for postoperative uveitis, macular oedema and neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy after phacoemulsification and intraocular lens (IOL) implantation in patients with uveitis. Method: This is a retrospective review of the medical records of 101 eyes of 101 patients. One eye was randomly selected for inclusion in patients who had bilateral surgery. Patients with juvenile arthritis, keratouveitis and lymphoma-associated uveitis were excluded. Results: At the first postoperative and final visits, visual acuity was significantly better (p<0.001), and 64.4% and 71.3% of patients, respectively, had achieved ≥2 Snellen's lines of visual improvement. The cumulative probability of doubling of the visual angle was 52% over 6 years of follow-up, and this occurred at a higher rate in the presence of preoperative retinal or optic nerve lesions (HR (95% Cl) 4.49 (1.41 to 14.29)). Within 3 months after operation, uveitis was more likely to develop in female patients (OR (95% Cl) 6.21 (1.41 to 27.43)) and in the presence of significant intraoperative posterior synechiae (OR (95% Cl) 8.43 (1.09 to 65.41)); macular oedema was more likely to develop in patients who developed postoperative uveitis (OR (95% Cl) 7.45 (1.63 to 34.16)). Nd:YAG capsulotomy occurred at a higher rate in patients aged ≤5 years (HR (95% Cl) 2.28 (1.06, 4.93)) and in those with hydrogel lOLs (HR (95% Cl) 3.71 (1.04 to 13.20)), and occurred at a lower rate in patients who had prophylactic systemic corticosteroids (HR (95% Cl) 0.25 (0.11 to 0.59)), with plate-haptic silicone lOLs (HR (95% Cl) 0.23 (0.08 to 0.64)) and three-piece silicone lOLs (HR (95% Cl) 0.19 (0.05 to 0.74)) in comparison to those with polymethylmethacrylate lOLs. Conclusion: Most patients with uveitis achieve improved visual acuity after phacoemulsification, but an increasing rate of visual loss is observed in those with pre-existent macular or optic nerve lesions. Identifying patients who are at risk of postoperative complications should help in patient counselling and to pre-empt these complications by using preoperative prophylactic corticosteroids, careful IOL selection and postoperative intensive corticosteroids.</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>Royaume-Uni</li>
<li>Égypte</li>
</country>
<region><li>Angleterre</li>
<li>Grand Londres</li>
</region>
<settlement><li>Londres</li>
</settlement>
</list>
<tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Elgohary, M A" sort="Elgohary, M A" uniqKey="Elgohary M" first="M. A." last="Elgohary">M. A. Elgohary</name>
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<name sortKey="Lightman, S S" sort="Lightman, S S" uniqKey="Lightman S" first="S. S." last="Lightman">S. S. Lightman</name>
<name sortKey="Obikpo, R" sort="Obikpo, R" uniqKey="Obikpo R" first="R." last="Obikpo">R. Obikpo</name>
<name sortKey="Okhravi, N" sort="Okhravi, N" uniqKey="Okhravi N" first="N." last="Okhravi">N. Okhravi</name>
<name sortKey="Towler, H M A" sort="Towler, H M A" uniqKey="Towler H" first="H. M. A." last="Towler">H. M. A. Towler</name>
</country>
<country name="Égypte"><noRegion><name sortKey="Elgohary, M A" sort="Elgohary, M A" uniqKey="Elgohary M" first="M. A." last="Elgohary">M. A. Elgohary</name>
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<country name="Australie"><noRegion><name sortKey="Mccluskey, P J" sort="Mccluskey, P J" uniqKey="Mccluskey P" first="P. J." last="Mccluskey">P. J. Mccluskey</name>
</noRegion>
<name sortKey="Singh, R P" sort="Singh, R P" uniqKey="Singh R" first="R. P." last="Singh">R. P. Singh</name>
</country>
</tree>
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</record>

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Outcome of phacoemulsification in patients with uveitis

Outcome of phacoemulsification in patients with uveitis

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri