VISUAL OUTCOME AFTER CATARACT SURGERY IN COMPLICATED CATARACT

AIMS: To study various factors responsible for visual outcome after cataract surgery in complicated cataract secondary to uveitis. SETTINGS AND STUDY DESIGN: A Retrospective, Clinical study was carried out at tertiary eye care center in central Maharashtra from Jan. 2002 to Jan. 2007 which included 60 eyes of 52 patients. METHODS AND MATERIAL: It was a retrospective study of patients with uveitis undergone cataract surgery between Jan. 2002 to Jan. 2007, at Shri Ganapati Netralaya, Jalna. It included patients of all age groups, both genders, diagnosed of complicated cataract due to uveits subjected to cataract surgery with IOL implantation and detailed preoperative and postoperative -UCVA, BCVA, SLE, and Fundus evaluation with at least 3 months follow up. Follow up was on 1'st post-operative day, 1 week post-operative, 1 month post-operative and 3 months postoperative. We excluded patients with complicated cataract other than uveitic origin, post-operative follow up less than 3 months and patients with ocular diseases other than uveitis. TESTS APPLIED: Paired & Unpaired t-test. RESULTS: 1) Visual acuity: BCVA (>6/12 in 43(71.67 %) eyes. 2) TYPE OF SURGERY: ECCE+IOL,(3) SICS+IOL,(5) SICS+AV(1) PE+IOL.(51) 3) Type of IOL used: PMMA,(46) HSM,(2) Acrylic.(11) 4) Postoperative complications:CME-1(1.66%), Recurrence of Uveitis-9(15%), PCO:19(31.66%), Posterior synaechie: 3 (5%, Hyphema:-2 (3.33%), Hypotony:-4 (6.66%), Secondary Glaucoma:-2 (3.33%) RD:-1 (1.66%). CONCLUSIONS: 1) Visual outcome after cataract surgery in complicated cataract is statistically significant (P<0.0001) in our study. 2) The best technique of surgery remains Phacoemulsification with in-the-bag IOL implantation of PCIOL. 3) Use of pupil dilating technique's (Iris hook, Sphincterotomy) is helpful in making adequate size capsulorrhexis and thereby reducing post-operative complications like anterior capsular opacification & capsular phimosis. 4) The most important predictor of successful cataract surgery in our study was meticulous control of preoperative inflammation followed by regular follow up after cataract surgery.