Background Inflammation caused by arthritis and long-term use of steroids such as prednisone contributes to the development of cataracts and a significant visual disability. Cataracts are commonly and very successfully treated with surgery. Risk factors for cataracts include posterior synechiae and longstanding ocular inflammation. Prevention of cataract development is crucial. However, not all preventive measures are successful, and further management consisting of medical and surgical techniques is often necessary. Various factors should be taken into consideration when deciding on cataract management, including timing of surgery and placement of an intraocular lens. Continued partnership between rheumatologists and ophthalmologists can help ensure favorable visual outcomes (Angeles-Han and Yeh, 2011).
Objectives To assess the influence of preoperative activity of RA on the extent of anterior chamber inflammation after phacoemulsification and intraocular lens implantation (IOL).
Methods Twenty seven RA (30 eyes) had CE with IOL implantation during a period of 2 years duration. Clinical, laboratory and ophthalmic assessments were done preoperatively and postoperatively at 3 days, one week and one month. The patients were given a comprehensive eye examination, including a visual acuity examination, test for anterior and posterior fragments, a slit lamp examination after pupil dilation, and a corneal examination.
Results On the third postoperative day and one week postoperatively, anterior chamber inflammation was observed in all 30 eyes. One month postoperatively, inflammation was found in 14 eyes only. Three patients had fibrin deposition, elevated intraocular pressure and macular edema. Increased titer of rheumatoid factor was the most significant factor to determine the persistent aqueous inflammation in the anterior chamber.
Conclusions Postoperative inflammation in RA patients can persist one month postoperatively. Rheumatoid factor may be a causative factor. Intraocular lens implantation in patients with control of preoperative and postoperative ocular inflammation could lead to favorable visual results.
Anqeles-Han S, and Yeh S: Prevention and Managment of Cataracts in Children with Juvenile Idiopathic Arthritis-Associated Uveitis. Curr Rheumatol Rep, 2011
Disclosure of Interest None Declared
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