Article Text

Download PDFPDF
Long-term visual acuity outcomes following cataract surgery in eyes with ocular inflammatory disease
  1. Sapna Gangaputra1,
  2. Craig Newcomb2,
  3. Rebecca Armour3,
  4. Dongseok Choi4,
  5. Gui-shuang Ying5,
  6. Sylvia Groth1,
  7. Hosne Begum6,
  8. Tonetta Fitzgerald5,
  9. Pichaporn Artornsombudh7,8,
  10. Ebenezer Daniel5,
  11. Nirali Bhatt5,
  12. Stephen Foster9,10,
  13. Douglas Jabs6,11,
  14. Grace Levy-Clarke12,13,
  15. Robert Nussenblatt12,
  16. James T Rosenbaum3,14,15,
  17. H Nida Sen12,
  18. Eric Suhler3,16,
  19. Jennifer Thorne6,11,
  20. Kurt Dreger6,7,17,18,
  21. Jeanine Buchanich17,
  22. John H Kempen10,19,20,21
  23. Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Research Group
  1. 1 Vanderbilt Eye Institute, Nashville, Tennessee, USA
  2. 2 Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  3. 3 Department of Ophthalmology, Oregon Health & Science University School of Medicine, Portland, Oregon, USA
  4. 4 Public Health and Preventive Medicine, Oregon Health & Science University School of Medicine, Portland, Oregon, USA
  5. 5 Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  6. 6 Wilmer Eye Institute, Johns Hopkins Medicine School of Medicine, Baltimore, Maryland, USA
  7. 7 Ophthalmology, Somdech Phra Pinklao Hospital, Bangkok, Thailand
  8. 8 Chulalongkorn University, Bangkok, Thailand
  9. 9 Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA
  10. 10 Sight for Souls, Fort Myers, Florida, USA
  11. 11 Center for Clinical Trials and Evidence Synthesis, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  12. 12 Laboratory of Immunology, National Eye Institute, Bethesda, Maryland, USA
  13. 13 The Tampa Bay Uveitis Center, St Petersburg, Florida, USA
  14. 14 Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
  15. 15 Legacy Devers Eye Institute at Good Samaritan Medical Center, Portland, Oregon, USA
  16. 16 Ophthalmology, Veterans Health Administration, Portland, Oregon, USA
  17. 17 Center for Occupational Biostatistics and Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
  18. 18 Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  19. 19 Departments of Ophthalmology and Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
  20. 20 Ophthalmology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia
  21. 21 MCM Eye Unit, MyungSung Christian Medical Center General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia
  1. Correspondence to Dr Sapna Gangaputra, Vanderbilt Eye Institute, Nashville, TN 37232, USA; sapna.gangaputra{at}vumc.org

Abstract

Purpose To evaluate the long-term visual acuity (VA) outcome of cataract surgery in inflammatory eye disease.

Setting Tertiary care academic centres.

Design Multicentre retrospective cohort study.

Methods A total of 1741 patients with non-infectious inflammatory eye disease (2382 eyes) who underwent cataract surgery while under tertiary uveitis management were included. Standardised chart review was used to gather clinical data. Multivariable logistic regression models with adjustment for intereye correlations were performed to evaluate the prognostic factors for VA outcomes. Main outcome measure was VA after cataract surgery.

Results Uveitic eyes independent of anatomical location showed improved VA from baseline (mean 20/200) to within 3 months (mean 20/63) of cataract surgery and maintained through at least 5 years of follow-up (mean 20/63). Eyes that achieved 20/40 or better VA at 1 year were more likely to have scleritis (OR=1.34, p<0.0001) or anterior uveitis (OR=2.2, p<0.0001), VA 20/50 to 20/80 (OR 4.76 as compared with worse than 20/200, p<0.0001) preoperatively, inactive uveitis (OR=1.49, p=0.03), have undergone phacoemulsification (OR=1.45 as compared with extracapsular cataract extraction, p=0.04) or have had intraocular lens placement (OR=2.13, p=0.01). Adults had better VA immediately after surgery, with only 39% (57/146) paediatric eyes at 20/40 or better at 1 year.

Conclusions Our results suggest that adult and paediatric eyes with uveitis typically have improved VA following cataract surgery and remain stable thereafter for at least 5 years.

  • Epidemiology
  • Inflammation
  • Lens and zonules
  • Treatment Surgery
  • Vision

Data availability statement

Data are available upon reasonable request. The data are funded by NIH and therefore available upon request.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available upon reasonable request. The data are funded by NIH and therefore available upon request.

View Full Text

Footnotes

  • Twitter @GangaputraSapna

  • Deceased Deceased

  • Contributors All authors contributed to the manuscript, either by caring for the patients whose data were included, collection of data, or abstraction and analysis of results. All authors critically reviewed the study proposal, analysis results and manuscript draft and provided feedback.

  • Funding National Eye Institute/National Institutes of Health grant 1R21 EY032592-01 (SG), grant 1R01 EY014943 (JHK) and Research to Prevent Blindness (New York, NY).

  • Disclaimer The funding organisations had no role in the design or conduct of this research. The content is solely the responsibility of the authors and does not necessarily represent the official views of any of the funding agencies.

  • Competing interests JTR: AbbVie (consultant); Gilead (consultant); Janssen (consultant); Eyevensys (consultant); UpToDate (author/royalties); Pfizer (financial support); Novartis (consultant); Roche (consultant); Alcon Research Institute (financial support); Horizon (financial support and consultant); Revolo (consultant); Neoleukin (consultant); Affibody (consultant); Celgene-Bristol Myers (Data Monitoring Committee); Eli Lilly (Clinical Endpoints Committee). GL-C: AbbVie (consultant, lecture fees); Allergan (grant support); Mallinckrodt (consultant, grant support); Sanofi (grant support, lecture fees). ES: Eyevensys (consultant); Santen (consultant); EyeGate (consultant, financial support); AbbVie (consultant, financial support); Clearside (consultant, financial support); EyePoint (consultant, financial support). SGa: Merit CRO (consultant); NEI (grant support); RPB (grant support). SGr: Olleyes (grant support). JT: AbbVie (consultant); ADVISE/MERIT, NEI (grant support); Gilead (consultant); Roche (consultant); Tarsier Pharma (equity owner); UpToDate (consultant). JHK: Gilead (consultant); Betaliq (equity owner); Tarsier Pharma (equity owner).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

Linked Articles

  • Highlights from this issue
    Frank Larkin