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Br J Ophthalmol 2004;88:1122-1124 doi:10.1136/bjo.2003.032482
  • Clinical science
    • Scientific reports

Steroid prophylaxis in eyes with uveitis undergoing phacoemulsification

  1. W R Meacock,
  2. D J Spalton,
  3. L Bender,
  4. R Antcliff,
  5. C Heatley,
  6. M R Stanford,
  7. E M Graham
  1. Tremona Road, Eye Unit, Southampton General Hospital, Southampton, Hants, UK
  1. Correspondence to: MrW Meacock Tremona Road, Eye Unit, Southampton General Hospital, Southampton, Hants, UK; wmeacockhotmail.com

    Abstract

    Aim: To compare the efficacy of two preoperative steroid regimens for cataract surgery in patients with uveitis.

    Methods: 40 uveitis patients with cataract underwent phacoemulsification and intraocular lens (IOL) implantation. Preoperatively they were randomised into two groups: group 1 (20 patients) received a single dose of intravenous methylprednisolone (15 mg/kg) half an hour before surgery, and group 2 (20 patients) received a 2 week course of oral prednisolone (0.5 mg/kg) which was tapered postoperatively. Preoperatively patients had aqueous flare and cells measured with the Kowa laser flare meter. On days 1, 7, 28, and 90 aqueous flare and cells were measured, and on days 7 and 90 fluorescein angiography was performed to determine the incidence of cystoid macular oedema (CMO).

    Results: At all postoperative visits the mean increase in flare was greater for group 1 (intravenous steroid). Patients with posterior synechiae had greater blood-aqueous barrier damage (BAB) postoperatively. There were no statistically significant differences in logMAR visual acuity and incidences of CMO between the two groups at 7 and 90 days.

    Conclusion: A 2 week course of oral prednisolone, tapered postoperatively, produced a better recovery of the BAB than a single dose of intravenous methylprednisolone and is thus the recommended preoperative regimen.

    Footnotes

    • This work was presented at Association for Research in Vision and Ophthalmology 2000 and ESCRS Congress in Nice 2002.

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