Posters

Cataract surgery in ocular tuberculosis: visual outcome and prognostic factors

Poster Details

First Author: S.Chatterjee INDIA

Co Author(s):    D. Agrawal                    

Abstract Details

Purpose:

Cataract surgery in eyes with ocular tuberculosis (OTB) is challenging because of persistent chronic uveitis, presence of broad based posterior synechiae, posterior segment complications and post-operative control of uveitis. The aim of the study is to evaluate the visual outcome following cataract surgery and identify factors prognosticating a good outcome.

Setting:

Cornea & Anterior Segment Services of MGM Eye Institute, Raipur, Chhattisgarh, India. Study period: January 2005 to August 2017.

Methods:

Retrospective interventional consecutive case series of 199 patients of uveitis undergoing phacoemulsification or extra-capsular cataract extraction. 36 patients (43 eyes) with laboratory diagnosis of OTB were included. Patients with less than 6 months follow-up were excluded. Each eye was considered as a unit, and 41 eyes (35 patients) were included for final analysis. Good outcome (defined as best spectacle corrected distant visual acuity (CDVA) 20/40 or better measured by LogMAR visual acuity charts) was correlated with different variables by multiple logistic regression to identify risk factors. A 2-tailed p value less than 0.05 was considered statistically significant.

Results:

PE was performed in 36(87.8%) and ECCE in 5(12.2%) eyes. Intra-ocular lens could not be implanted in 1 eye due to posterior capsule rupture. Iris manipulation was required in 36(87.8%) eyes. Mean follow-up was 37.4±27.2 (6-108) months. Mean pre-operative CDVA of 1.25±1.18 improved to 0.38±0.2 at 1 month post-operatively and 0.45±0.3 at last follow-up (p<0.0001). Good visual outcome in 24(58.5%) eyes, 6(14.6%) eyes had 20/200 or less. Good outcome was associated with good pre-operative uveitis control (p=0.002), phacoemulsification (p=0.007), acrylic intra-ocular lens (p=0.008), absent posterior segment disease (p<0.0001) and good post-operative uveitis control (p=0.06).

Conclusions:

Despite challenges, cataract surgery in OTB is safe and has good outcome in slightly more than half of the patients. Intra-operatively most patients require iris and pupil manipulation. Good outcome is associated with good pre- and post-operative uveitis control, phacoemulsification with acrylic intra-ocular lens implantation, and absence of posterior segment disease.

Financial Disclosure:

None