Race and Persistent Uveitis After Cataract Surgery
American Journal of Ophthalmology, October 2019
Reddy et al. set out to identify risk factors for the occurrence of persistent anterior uveitis (PAU) secondary to uncomplicated cataract extraction in patients with no history of uveitis or autoimmune disease. The authors determined that African Americans are more likely than others to experience this postoperative condition and that PAU does not predict worse visual outcomes.
This study was a three-year, single-center retrospective series of patients who did not have autoimmune disease or previous uveitis. They had undergone cataract surgery by phacoemulsification with implantation of an IOL. A total of 3,013 eyes (2,019 patients) were included in the study; of these, 61 eyes (48 patients) had post-op PAU. Cystoid macular edema (CME) also developed in 18 of these 61 eyes.
The authors calculated relative risk (RR) to determine whether certain characteristics were linked to the probability of PAU. These included age, sex, race/ethnicity (white, African American, Hispanic, or other), operating time, cumulative dissipated energy during phacoemulsification, visual acuity, intraocular pressure (IOP), anterior chamber cell grade, CME presence, and steroid use during follow-up.
Results showed that African Americans were much more likely than whites to have PAU after uncomplicated cataract extraction (RR, 11.3; p < .0001). No other patient-level characteristic was identified as a risk factor for PAU. Three months postoperatively, the visual acuity of patients with and without PAU was comparable, but the mean IOP was slightly higher in those with PAU. Among patients with PAU, visual acuity and IOP results were similar for the various races.
The authors concluded that, after cataract surgery, African Americans have a high risk of PAU; however, this prolonged inflammation does not seem to affect long-term visual outcomes.
The original article can be found here.