Outcome and Prognostic Factors of Phacoemulsification Cataract Surgery in Vogt-Koyanagi-Harada Uveitis

Yan Ji; Ke Hu; Can Li; Pinghua Li; Aize Kijlstra; Allen Omid Eghrari; Bo Lei; Liping Du; Wenjuan Wan; Peizeng Yang

doi:10.1016/j.ajo.2018.08.041

Outcome and Prognostic Factors of Phacoemulsification Cataract Surgery in Vogt-Koyanagi-Harada Uveitis

Yan Ji, Ke Hu, Can Li, Pinghua Li, Aize Kijlstra, Allen Omid Eghrari, Bo Lei, Liping Du, Wenjuan Wan, Peizeng Yang^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

12 Citations (Web of Science)

Abstract

PURPOSE: To investigate visual outcome and prognostic factors following cataract surgery in patients with Vogt-Koyanagi-Harada (VKH) disease.

DESIGN: Retrospective, interventional case series.

METHODS: The history, clinical characteristics, best corrected visual acuity (BCVA), full-field electroretinogram (ERG), intraocular inflammation, complications, and extraocular manifestations were analyzed retrospectively.

RESULTS: One hundred and forty-eight male (214 eyes) and 138 female (194 eyes) VKH patients with complicated cataract were included. Surgery was performed on 352 eyes after complete control of intraocular inflammation for at least 3 months. In another set of 56 eyes, surgery was done 1 month after intraocular inflammation control. There was no difference in postoperative complications or BCVA between these 2 groups. The main complications after surgery were hyphema, ocular hypertension, and moderate anterior chamber reaction. Average preoperative visual acuity was 0.08. At last visit, BCVA was improved in 405 eyes (99.3%). The preoperative BCVA, treatment delay after disease onset, preoperative intraocular hypertension, and iris synechiae were associated with final visual outcome. Other parameters such as postoperative inflammation, IOL type, and presence of extraocular VKH features did not affect final BCVA. Poor visual acuity was caused by optic nerve atrophy, choroidoretinal neovascularization, and subretinal fibrosis. Poor postoperative BCVA was associated with an abnormal preoperative ERG profile.

CONCLUSIONS: Phacoemulsification and IOL implantation in VKH patients can be safely and successfully performed in quiet eyes even after 1 month following the last signs of inflammation. Visual prognosis was associated with preoperative BCVA, treatment delay after disease onset, preoperative intraocular hypertension, iris synechiae, and presence of preoperative ERG abnormalities. ((C) Elsevier Inc. All rights reserved.)

Original language	English
Pages (from-to)	121-128
Number of pages	8
Journal	American Journal of Ophthalmology
Volume	196
DOIs	https://doi.org/10.1016/j.ajo.2018.08.041
Publication status	Published - Dec 2018

Keywords

INTRAOCULAR LENSES
DISEASE

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10.1016/j.ajo.2018.08.041

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@article{df24c87f70be48479fb168688a65d723,

title = "Outcome and Prognostic Factors of Phacoemulsification Cataract Surgery in Vogt-Koyanagi-Harada Uveitis",

abstract = "PURPOSE: To investigate visual outcome and prognostic factors following cataract surgery in patients with Vogt-Koyanagi-Harada (VKH) disease.DESIGN: Retrospective, interventional case series.METHODS: The history, clinical characteristics, best corrected visual acuity (BCVA), full-field electroretinogram (ERG), intraocular inflammation, complications, and extraocular manifestations were analyzed retrospectively.RESULTS: One hundred and forty-eight male (214 eyes) and 138 female (194 eyes) VKH patients with complicated cataract were included. Surgery was performed on 352 eyes after complete control of intraocular inflammation for at least 3 months. In another set of 56 eyes, surgery was done 1 month after intraocular inflammation control. There was no difference in postoperative complications or BCVA between these 2 groups. The main complications after surgery were hyphema, ocular hypertension, and moderate anterior chamber reaction. Average preoperative visual acuity was 0.08. At last visit, BCVA was improved in 405 eyes (99.3%). The preoperative BCVA, treatment delay after disease onset, preoperative intraocular hypertension, and iris synechiae were associated with final visual outcome. Other parameters such as postoperative inflammation, IOL type, and presence of extraocular VKH features did not affect final BCVA. Poor visual acuity was caused by optic nerve atrophy, choroidoretinal neovascularization, and subretinal fibrosis. Poor postoperative BCVA was associated with an abnormal preoperative ERG profile.CONCLUSIONS: Phacoemulsification and IOL implantation in VKH patients can be safely and successfully performed in quiet eyes even after 1 month following the last signs of inflammation. Visual prognosis was associated with preoperative BCVA, treatment delay after disease onset, preoperative intraocular hypertension, iris synechiae, and presence of preoperative ERG abnormalities. ((C) Elsevier Inc. All rights reserved.)",

keywords = "INTRAOCULAR LENSES, DISEASE",

author = "Yan Ji and Ke Hu and Can Li and Pinghua Li and Aize Kijlstra and Eghrari, {Allen Omid} and Bo Lei and Liping Du and Wenjuan Wan and Peizeng Yang",

year = "2018",

month = dec,

doi = "10.1016/j.ajo.2018.08.041",

language = "English",

volume = "196",

pages = "121--128",

journal = "American Journal of Ophthalmology",

issn = "0002-9394",

publisher = "Elsevier Science",

}

TY - JOUR

T1 - Outcome and Prognostic Factors of Phacoemulsification Cataract Surgery in Vogt-Koyanagi-Harada Uveitis

AU - Ji, Yan

AU - Hu, Ke

AU - Li, Can

AU - Li, Pinghua

AU - Kijlstra, Aize

AU - Eghrari, Allen Omid

AU - Lei, Bo

AU - Du, Liping

AU - Wan, Wenjuan

AU - Yang, Peizeng

PY - 2018/12

Y1 - 2018/12

N2 - PURPOSE: To investigate visual outcome and prognostic factors following cataract surgery in patients with Vogt-Koyanagi-Harada (VKH) disease.DESIGN: Retrospective, interventional case series.METHODS: The history, clinical characteristics, best corrected visual acuity (BCVA), full-field electroretinogram (ERG), intraocular inflammation, complications, and extraocular manifestations were analyzed retrospectively.RESULTS: One hundred and forty-eight male (214 eyes) and 138 female (194 eyes) VKH patients with complicated cataract were included. Surgery was performed on 352 eyes after complete control of intraocular inflammation for at least 3 months. In another set of 56 eyes, surgery was done 1 month after intraocular inflammation control. There was no difference in postoperative complications or BCVA between these 2 groups. The main complications after surgery were hyphema, ocular hypertension, and moderate anterior chamber reaction. Average preoperative visual acuity was 0.08. At last visit, BCVA was improved in 405 eyes (99.3%). The preoperative BCVA, treatment delay after disease onset, preoperative intraocular hypertension, and iris synechiae were associated with final visual outcome. Other parameters such as postoperative inflammation, IOL type, and presence of extraocular VKH features did not affect final BCVA. Poor visual acuity was caused by optic nerve atrophy, choroidoretinal neovascularization, and subretinal fibrosis. Poor postoperative BCVA was associated with an abnormal preoperative ERG profile.CONCLUSIONS: Phacoemulsification and IOL implantation in VKH patients can be safely and successfully performed in quiet eyes even after 1 month following the last signs of inflammation. Visual prognosis was associated with preoperative BCVA, treatment delay after disease onset, preoperative intraocular hypertension, iris synechiae, and presence of preoperative ERG abnormalities. ((C) Elsevier Inc. All rights reserved.)

AB - PURPOSE: To investigate visual outcome and prognostic factors following cataract surgery in patients with Vogt-Koyanagi-Harada (VKH) disease.DESIGN: Retrospective, interventional case series.METHODS: The history, clinical characteristics, best corrected visual acuity (BCVA), full-field electroretinogram (ERG), intraocular inflammation, complications, and extraocular manifestations were analyzed retrospectively.RESULTS: One hundred and forty-eight male (214 eyes) and 138 female (194 eyes) VKH patients with complicated cataract were included. Surgery was performed on 352 eyes after complete control of intraocular inflammation for at least 3 months. In another set of 56 eyes, surgery was done 1 month after intraocular inflammation control. There was no difference in postoperative complications or BCVA between these 2 groups. The main complications after surgery were hyphema, ocular hypertension, and moderate anterior chamber reaction. Average preoperative visual acuity was 0.08. At last visit, BCVA was improved in 405 eyes (99.3%). The preoperative BCVA, treatment delay after disease onset, preoperative intraocular hypertension, and iris synechiae were associated with final visual outcome. Other parameters such as postoperative inflammation, IOL type, and presence of extraocular VKH features did not affect final BCVA. Poor visual acuity was caused by optic nerve atrophy, choroidoretinal neovascularization, and subretinal fibrosis. Poor postoperative BCVA was associated with an abnormal preoperative ERG profile.CONCLUSIONS: Phacoemulsification and IOL implantation in VKH patients can be safely and successfully performed in quiet eyes even after 1 month following the last signs of inflammation. Visual prognosis was associated with preoperative BCVA, treatment delay after disease onset, preoperative intraocular hypertension, iris synechiae, and presence of preoperative ERG abnormalities. ((C) Elsevier Inc. All rights reserved.)

KW - INTRAOCULAR LENSES

KW - DISEASE

U2 - 10.1016/j.ajo.2018.08.041

DO - 10.1016/j.ajo.2018.08.041

M3 - Article

C2 - 30194930

VL - 196

SP - 121

EP - 128

JO - American Journal of Ophthalmology

JF - American Journal of Ophthalmology

SN - 0002-9394

ER -