MAY 03, 2018
Glaucoma
This retrospective study examined the prevalence of persistent anterior uveitis (PAU) after combined phacoemulsification and endoscopic cyclophotocoagulation (ECP) based on race.
Study design
Researchers included 233 eyes with primary open-angle glaucoma who underwent combined cataract surgery with ECP. PAU was defined as presence of postoperative inflammation at 3 months postop. Patients were categorized according to self-reported race.
Outcomes
The overall prevalence of PAU was 22.4% and was most common among African Americans (48.7%) compared to Asians (33.3%), Hispanics (18.8%), and whites (15.8%). The relative risk for PAU was 3.08 for African Americans compared to whites (P<0.0001).
Vision outcomes, IOP and reduction in the number of IOP-lowering medications were similar between races.
Limitations
This was not a prospective study and is therefore limited by its retrospective design. All patients underwent ECP treatment using similar settings, yet many surgeons modify settings based on ciliary body pigmentation. This may have led to different rates of PAU.
Clinical significance
African American patients undergoing combined phacoemulsification and ECP should be aware of their increased risk for PAU, and will possibly need prolonged postoperative steroids. The increased risk for PAU is not associated with poorer visual and/or IOP outcomes.
Physicians should consider alternate routes for administrating steroids (i.e., subconjunctival or intracameral) for African American patients.