Inflammation management important for surgery in patients with uveitis
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WAIKOLOA, Hawaii — When performing surgery on patients with uveitis, key points include controlling preoperative inflammation and being willing to question a diagnosis, according to a speaker at Retina 2022.
“Just remember, when you’re doing surgery on these patients, No. 1, make sure you’re controlling the inflammation pre-surgery and post-surgery,” Sunil K. Srivastava, MD, said.
Although many cases that require vitreoretinal surgery may be urgent, there are other surgeries that are not as critical, so keeping inflammation under control is an important step, Srivastava said.
In elective cases such as IOL exchanges or puckers, Srivastava aims for 3 months of quiescence. In cases of recent retinal detachments, postoperative steroids and mechanisms to control infection are desired.
“I will decide between using a combination of oral steroids or intravitreal steroids if I know they don’t have an infection to keep the eyes quiet preoperatively and postoperatively,” Srivastava said.
After surgery, it is important to watch for signs of unusual postoperative inflammation.
If the case does not fit the current diagnosis, or if patient information and data do not make sense, it might be helpful to assume all information is incorrect and restart the diagnostic course, Srivastava said.
“If you’re going to do a diagnostic procedure, make sure that you’re talking to everybody,” Srivastava said.
“The final thing, most importantly, is when you’re thinking of these postoperative infectious cases, make sure you’re consistent. Make sure you’re looking at the lens and treating them appropriately,” he said.
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Srivastava SK. Vitreoretinal surgery in the uveitis patient. Presented at: Retina 2022; Jan. 15-21, 2022; Waikoloa, Hawaii.
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