This retrospective, interventional case series of 286 patients (408 eyes) assessed visual outcome and prognostic factors in patients with Vogt-Koyanagi-Harada (VKH) undergoing cataract surgery between September 2008 and December 2017. Two groups were reviewed. The first group (352 eyes) had their inflammation controlled for three months prior to surgery and the second group (56 eyes) had their inflammation controlled for one month prior to surgery. Inflammation was controlled with topical and systemic steroids in combination with either cyclosporine or cyclophosphamide. All patients had standard cataract surgery and there were no intraoperative complications such as posterior capsular rupture, iris injury or failure of circular capsulorrhexis. Forty eyes (9.8%) had hyphaema postoperatively which resolved within a few days. Ocular hypertension occurred in 54 eyes (13.2%) postoperatively, all of which returned to normal level within two to 10 days. Twenty-one eyes (5.1%) had a recurrence of intraocular inflammation during the follow-up period all of which was controlled by systemic corticosteroids combined with other immunosuppressants. Best corrected vision improved in 405 eyes (99.35) and at the last follow-up 387 eyes (94.9%) achieved a final best-corrected vision of 0.1 or better. There was no statistical difference in the postoperative follow-up between those patients who had their inflammation controlled for one month as opposed to three months. This suggests that cataract surgery is safe after one month of no inflammation as opposed to previously recommending waiting three months. Further studies with larger patient numbers are, however, required as they only had relatively small number of patients in the one month group.
Cataract surgery in patients with Vogt-Koyanagi-Harada
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