Combined phacoemulsification and deep anterior vitrectomy with intravitreal triamcinolone infection for complicated cataract and vitreous opacities due to recurrent uveitis

ABSTRACT

To evaluate the influence of combined cataract surgery with deep anterior vitrectomy and intravitreal injection of triamcinolone on the visual acuity and the course of the disease in patients with recurrent uveitis. Eleven eyes of eleven patients with medically controlled recurrent uveitis with complicated cataract and vitreous esudates nderent a combined phacoemulsification [or hacoasiration in cases of soft cataract0 and deep anterior virectomy for removal of lens opacity and vitreous debris with intravitreal injection of long acting steroid as a prophylactic measure against recurrence. Visual acuity was significantly improved in 9 eyes [81.8%] at the end of first month postoperatively and remained stationary thereafter. Recurrence of uveitis was significantly reduced and was noted in three eyes [27.2%], all of them had mild to moderate attacks which were controlled medically. Central macular thickness was measured using OCT in 5 patients preoperatively with mean of 353.60 +/- 44.27 micro and at 3 and 6 months postoperatively and was 225.20 +/- 34.04 micro and 241.80 +/- 37.73 micro respectively. Intraocular pressure rise was detected at early postoperative period in only two eyes [18.2%]. Both had mild elevation and pressure was controlled medically. No other complications were recorded. Combined phacoemulsification and deep anterior vitrectomy with IVTA injection is relatively safe and effective procedure in the treatment of complicated cataract and vitreous opacities in uveitic patient, improving visual outcome and reducing recurrence of uveities