Male sex, erythema nodosum, and electroretinography as predictors of visual prognosis after cataract surgery in patients with Behcet disease

PURPOSE: To evaluate factors that predict the visual prognosis after cataract surgery in patients with Behcet disease. SETTING: The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. DESIGN: Retrospective clinical study. METHODS: Patients with Behcet disease and complicated cataract had phacoemulsification and intraocular lens implantation between September 2008 and March 2011. Analyzed were the corrected distance visual acuity (CDVA), full-field electroretinogram (ERG) results, intraocular inflammation, extraocular manifestations, and complications before and after surgery. RESULTS: Twenty-one men (26 eyes) and 6 women (10 eyes) Behcet disease patients with complicated cataract were enrolled. There were no postoperative complications, although a mild to moderate anterior chamber reaction occurred in all patients. At the last visit, the CDVA was improved in 35 eyes. Twenty-seven eyes (75%) achieved a final CDVA of 0.1 or better. No female patient had obvious fundus complications, and all female patients achieved a final CDVA of 0.25 or better. The common causes for poor visual prognosis were optic atrophy, atrophy of the retina, and cystoid macular edema. Eyes with marked ERG a-wave and b-wave abnormalities had a significantly worse postoperative CDVA. Seven (10 eyes) of 8 patients (11 eyes) with a history of erythema nodosum had a postoperative visual acuity below 0.1. CONCLUSIONS: Phacoemulsification and IOL implantation in patients with Behcet disease can be safely and successfully performed in quiet eyes. A poor visual prognosis was associated with male sex, severe fundus complications, and erythema nodosum and could be predicted by ERG abnormalities. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. J Cataract Refract Surg 2012; 38:1382-1388