Assessing inflammation using laser flare photometer, following intravitreal dexamethasone implant in patients of uveitis undergoing cataract surgery: a randomized control study

Session Details

Session Title: Cataract Surgery Equipment/Instrumentation/Surgical Devices/OVDs

Session Date/Time: Tuesday 10/10/2017 | 16:00-17:00

Paper Time: 16:34

Venue: Room 4.1

First Author: : S. Yangzes INDIA

Co Author(s): :    G. Gupta   J. Ram   V. Gupta   R. Singh   R. Bansal        

Abstract Details

Purpose:

To assess the post-operative inflammation using laser flare photometer, following phacoemulsification with or without single intraoperative intravitreal dexamethasone implant in addition to standard of care, in patients of uveitis with cataract.

Setting:

Advanced Eye Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India-160012

Methods:

It is a prospective single masked randomized control study. 30 eyes of 30 patients with uveitis with visually significant cataract were included and randomized into 2 groups: (i)standard of care group (SOC group): which received standard of care treatment for uveitis alone with phacoemulsification and posterior chamber intraocular lens (PCIOL) implantation; (ii)Dexamethasone implant group (DEXA group): which received intraoperative intravitreal injection of dexamethasone implant, in addition to standard of care. Patients were followed atleast till 6 months and laser flare photometry (LFP), best corrected visual acuity (BCVA), Intraocular pressure (IOP), central macular thickness (CMT) was recorded on every visit

Results:

DEXA group had significantly less postoperative flare (P<0.05) as compared to SOC group on postoperative day 3, 1 week, 2 weeks, 4 weeks, 6 weeks and 24 weeks. Recovery of flare to its preoperative value occurred within 4 weeks in DEXA group, whereas it took 3 months in SOC group. Mean CMT was significantly lower (P<0.04), in DEXA group at postoperative 6 weeks and 24 weeks. 37.5% cases developed CME in SOC group but none in DEXA group. Final mean BCVA was significantly better in DEXA group (P=0.02). No case developed steroid induced ocular hypertension or glaucoma.

Conclusions:

Use of intraoperative intravitreal dexamethasone implant while doing phacoemulsification with IOL implantation in cases of uveitis with cataract, results in less postoperative inflammation and faster recovery, better visual outcome, less incidence of CME and no or minimal adverse effects. So we conclude that, dexamethasone implant is a safe and effective option for preventing and managing the postoperative inflammation in uveitic cataract cases and is also useful in preventing the complications of cataract surgery in uveitis cases.

Financial Disclosure:

NONE