Ramesh R. Sivaraj

Long-term biocompatibility and visual outcomes of a hydrophilic acrylic intraocular lens in patients with uveitis

Purpose To report the long‐term visual outcomes and biocompatibility of a single‐piece hydrophilic acrylic intraocular lens (IOL) in patients with uveitis having cataract surgery. Setting Tertiary referral center, Birmingham, United Kingdom. Design Retrospective case review. Methods The review included consecutive uveitis patients in whom phacoemulsification and acrylic IOL implantation was performed by the same surgeon. Outcomes measures are reported as rate/eye‐year and included visual acuity and signs of bioincompatibility. Results The review identified 171 eyes (140 patients; mean age 51 years [range 16 to 85 years]) with uveitis. The mean follow‐up was 3.8 years (range 0.9 to 10.3 years). Signs of uveal bioincompatibility were found in 31 eyes, with visually insignificant deposits on the IOL in 17 eyes. The rate of uveal bioincompatibility was 0.06/eye‐year. Signs of capsule bioincompatibility were found in 107 (63%) of 171 eyes (0.31/eye‐year). Posterior capsule opacification was documented in 102 eyes (0.29/eye‐year); neodymium:YAG laser capsulotomy was required in 31 eyes (0.05/eye‐year). The rate of failure to maintain a 3 logMAR line improvement in corrected distance visual acuity (CDVA) was 0.08/eye‐year; to maintain better than 0.3 logMAR, 0.15/eye‐year; and to maintain either, 0.04/eye‐year. At 1 year, 85% of eyes had a CDVA of better than 0.3 logMAR or maintained a 3 logMAR–line improvement. Eyes with preexisting macular or optic nerve disease had significantly worse visual outcomes. Conclusions The long‐term safety profile of the hydrophilic acrylic IOL was good in uveitis cases, leading to good visual outcomes and a low rate of vision‐impairing uveal and capsule complications. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

Clinical Features of Patients with Diabetes Mellitus Presenting with Their First Episode of Uveitis

Purpose: Little is known about uveitis in patients with diabetes mellitus (DM). The authors studied diabetic patients with their first episode of uveitis. Methods: Cross-sectional, case note study documenting the uveitis, underlying cause/syndrome, treatment, type of DM and treatment, and any diabetic retinopathy. Results: There were 34 patients (M/F: 17/17, 48 eyes) with their first uveitis episode (33 had type 2 DM). Mean age of onset of DM 49 years and uveitis 56 years. Uveitis was bilateral in 14 (45%), with most having idiopathic anterior uveitis. Visual acuity 6/18–6/60 in 15 eyes, and worse than 6/60 in 11 eyes. There was 3–4+ flare in 16 eyes, 3–4+ anterior chamber cells in 13 eyes. Diabetic retinopathy was seen in 20 (42%) eyes, and mean blood glucose was 13.64 mmol/L in 11 patients. Conclusions: Diabetic patients presenting with uveitis, whatever the aetiology, may have severe inflammation, reduced vision, and poor glycaemic control.