Hydrophilic acrylic IOLs produce good outcomes in uveitis

This long-term retrospective study found that hydrophilic acrylic IOL implantation yields good visual outcomes and a low rate of complications in patients with uveitis.

This is believed to be the largest study of uveitic eyes undergoing cataract surgery with a single IOL material and with the same surgeon. Most experts in uveitis agree that hydrophobic acrylic IOLs are well-tolerated in patients with uveitis.

The study included 140 consecutive patients (171 eyes) with uveitis and cataract who underwent phacoemulsification and implantation of a single-piece Rayner hydrophilic acrylic IOL. The mean follow-up was 3.8 years and ranged from 0.9 to 10.3 years.

At one year, 85 percent of eyes had a CDVA of better than 0.3 logMAR or maintained a 3 logMAR-line improvement.

Throughout the follow-up period, signs of uveal bioincompatibility were found in 31 eyes (0.06/eye-year), with visually insignificant deposits on the IOL in 17 eyes. Formation of posterior synechiae occurred in 13 percent of patients. Signs of capsule bioincompatibility were found in 107 (63 percent) of eyes (0.31/eye-year). At six months, 25 percent had posterior subcapscular opacity, as did 60 percent at 15 months. Eighteen percent underwent YAG laser capsulotomy (0.05/eye-year).

Flare was mild in 6 percent of cases and severe in 3 percent at three months. Eyes with pre-existing macular or optic nerve disease had significantly worse visual outcomes.