Deviation from refractive target frequent in uveitic cataract surgery
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A large proportion of patients with uveitis who are undergoing cataract surgery may have refractive outcomes that deviate from the intended target.
“Refractive outcomes have not been well delineated by studies for this patient population. And yet this information is important for surgical risk evaluation and better preoperative patient counseling,” Steven Seto, MD, said at the virtual Association for Research in Vision and Ophthalmology meeting.
The study was a single-center retrospective chart review of patients with a history of uveitis undergoing cataract extraction between January 2016 and June 2019 at the University of Wisconsin.
Sixty-five eyes of 48 patients were included. Age ranged between 21 and 87 years. Anterior uveitis was the most common, 20% of patients were on baseline immunomodulatory therapy, and about 50% were on corticosteroids. Perioperatively, 40% of patients received systemic or injectable corticosteroids in addition to postoperative topical steroids. One-piece acrylic IOLs were used in most cases, with about one-fifth of eyes receiving a three-piece acrylic lens.
Mean preoperative corrected distance visual acuity improved from 20/100 to 20/30 postop, with 80% of eyes achieving 20/40 or better. The mean deviation from refractive target was 0.6 D.
“Data show that 30 eyes (46.2%) deviated greater than 0.5 D from refractive goal and 10 eyes (15.4%) deviated more than 1 D,” Seto said.
Association between deviation from refractive target and biometric data, location of uveitis, other preoperative and postoperative exam findings, and perioperative management were assessed, but “no significant association was identified between refractive error greater than 0.5 D or 1 D from target and any of the tested variables,” Seto said.
There was a trend toward an association in patients with a younger age and preoperative corticosteroid treatment, but this was not statistically significant.
“Multicenter studies on a larger population are needed to better define risk factors for this variability in refractive outcome,” Seto said.
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Kopplin L, et al. Refractive outcomes following uveitic cataract surgery. Presented at: Association for Research in Vision and Ophthalmology annual meeting; June 12, 2020 (virtual meeting).
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