Posters

A novel protocol for cataract surgery in patients with ocular surface disease

Poster Details

First Author: A.Lazaridis GERMANY

Co Author(s):    N. Alfahad   M. Ahmad   S. Rauz              

Abstract Details

Purpose:

To present the clinical outcomes, visual rehabilitation and complications after cataract surgery in patients with ocular surface disease (OSD) under perioperative administration of topical non-preserved dexamethasone (npDEX), intravenous methylprednisolone (IV-MP) and amniotic membrane transplantation (AMT).

Setting:

Birmingham and Midland Eye Centre, UK

Methods:

Medical records of 187 consecutive cataract surgeries in patients with OSD were reviewed. All patients underwent phacoemulsification through a clear corneal incision, AMT and received npDEX and IV-MP perioperatively. One hundred sixty cases with ocular mucous membrane pemphigoid (oMMP;n=75), Stevens-Johnson syndrome (SJS;n=5)/toxic epidermal necrolysis (TEN;n=3), atopic keratoconjunctivitis (AKC;n=19), peripheral ulcerative keratitis (PUK;n=26) and OSD associated with systemic autoimmune diseases (e.g. rheumatoid arthritis, Sjögren syndrome) (AIOSD;n=32), with a minimum 6-month follow-up, were included. The OSD was in all cases under control for at least 3 months before surgery. The clinical outcomes, complications and best-corrected visual acuity (BCVA) were analysed.

Results:

The eyes with cicatrising conjunctivitis (oMMP, SJS/TEN, AKC) showed a significant improvement of BCVA at 3 and 6 months (P≤0.001). Serious postoperative complications included persistent epithelial defects, corneal thinning and progression of cicatrisation in 8 out of 102 cases (7.8%). The eyes with PUK and AIOSD also showed a significant improvement of BCVA at 3 and 6 months (P≤0.001). Serious postoperative complications included the reactivation of sclerokeratitis, scleral and/or corneal thinning, corneal vascularisation and graft failure in 7 out of 58 cases (12.1%).

Conclusions:

Clear-cornea cataract surgery in patients with OSD under perioperative administration of npDEX, IV-MP and AMT may result in significant improvement of visual acuity with reduced incidence of exacerbation of the underlying disease, sclerocorneal complications, progression of cicatrisation and inflammation.

Financial Disclosure:

None