ASSESSMENT OF VISUAL ACUITY AND COMPLICATIONS POST CATARACT SURGERY IN PATIENTS WITH UVEITIS IN TERTIARY CARE HOSPITAL

Shubhangi Chaudhary, W. M. Chavan
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Abstract

Aim and Objectives Aim:To study the visual acuity and operative complications after cataract surgery in patients with uveitis in tertiary care hospital Objectives: 1.To study factors affecting visual acuity. 2.To study surgical complications post cataract surgery in uveitis patients. Materials and Methods:A total of 18 patients were taken, data was collected from all the selected patients using a structured proforma meeting the objectives of the study. • Inclusion Criteria:1.All complicated cataract patients attending ophthalmology OPD 2.A quite eye (without inflammation) for atleast 3 months • Exclusion Criteria: 1.Cataract due to causes other than uveitis 2.Patients with posterior segment pathology Patients were scheduled for follow up on post op day 1, day 3 , day 7 , day 15, day 30, day 60, day 90. Results: The prevalance was more common in males compared to females. Out of 18 patients, 14 (77%) underwent SICS with PCIOL implantation and 4 (22%) underwent phacoemulsification with PCIOL. Intra-operative complications were noted as small non-dilating pupil, peripheral anterior synechiae, pupillary membrane, incomplete capsulorhexis, iris prolapse. In 7 (38%) patients sphincterectomy was done and in 4 (22%) patients stretch pupilloplasty was done. Immediate post-op complications that were noted were anterior chamber reaction and pigment dispersion. Late post-op complications that were noted were posterior capsular opacification Dense posterior synechiae were encountered in 12 (66%) patients and excessive conjunctival bleeding in 6(33%) patients. There was improvement in visual outcomes as follows 8 patients had 6/6 vision, 6 patients had 6/18 vision where as remaining 4 patients had 6/36 vision due to early development of posterior capsular opacification. Conclusion: Cataract development is a very common occurrence in any form of anterior and intermediate uveitis because of chronic intraocular inflammation, long term use of corticosteroids. Reported incidence of cataract in uveitic patients is about 25% in juvenile rheumatoid arthritis and 75% in chronic anterior uveitis. It is possible to achieve successful visual outcomes following cataract surgery in uveitis by proper management of pre-operative inflammation and close post-operative observation. Management of uveitic cataract requires careful case selection, proper timing of surgery, and close monitoring with appropriate handling of complications that may occur.
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评估三级医院葡萄膜炎患者白内障手术后的视力和并发症
目的和目标 目的:研究三级医院葡萄膜炎患者白内障手术后的视力和手术并发症:1.研究影响视力的因素。2.研究葡萄膜炎患者白内障手术后的手术并发症。材料与方法:共抽取了 18 名患者,使用符合研究目标的结构化表格收集所有入选患者的数据。Â- 纳入标准:1.所有到眼科门诊就诊的复杂性白内障患者 2.至少有 3 个月的正常眼球(无炎症) Â- 排除标准:1:1.由葡萄膜炎以外的原因引起的白内障 2.后段病变患者 患者将在术后第 1 天、第 3 天、第 7 天、第 15 天、第 30 天、第 60 天和第 90 天接受随访。结果男性发病率高于女性。在 18 名患者中,14 人(77%)接受了 SICS 并植入 PCIOL,4 人(22%)接受了超声乳化并植入 PCIOL。术中并发症包括小瞳孔不散开、周边前房裂缝、瞳孔膜、不完全包膜、虹膜脱垂。7例(38%)患者进行了括约肌切除术,4例(22%)患者进行了瞳孔拉伸成形术。术后即刻出现的并发症是前房反应和色素分散。术后晚期并发症包括后囊不透明,12 例(66%)患者出现致密的后巩膜,6 例(33%)患者结膜出血过多。视力改善情况如下:8 名患者的视力为 6/6,6 名患者的视力为 6/18,其余 4 名患者的视力为 6/36,原因是后囊变早期。结论由于慢性眼内炎症和长期使用皮质类固醇,白内障的发生在任何形式的前葡萄膜炎和中间葡萄膜炎中都非常常见。据报道,葡萄膜病患者的白内障发病率在幼年类风湿性关节炎中约为 25%,在慢性前葡萄膜炎中约为 75%。通过妥善处理术前炎症和术后密切观察,葡萄膜炎患者在接受白内障手术后有可能获得成功的视觉效果。葡萄膜炎性白内障的治疗需要谨慎选择病例、选择适当的手术时机、密切监测并妥善处理可能出现的并发症。
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