Cataract Surgery in the Setting of Scleritis

Ocul Immunol Inflamm. 2021 Nov 17;29(7-8):1540-1543. doi: 10.1080/09273948.2020.1754434. Epub 2020 May 28.

Abstract

Purpose: To report the clinical profile of cataract and its surgical management in a scleritis cohort from India.Methods: We conducted a retrospective review of medical records of 39 eyes of 32 consecutive patients with scleritis who underwent cataract surgery in a tertiary eye care institute.Results: The mean age at presentation was 50.9 ± 11.1 years and 65.6% of the patients were female. Five patients (15.6%) were ≤ 40 years of age. Necrotizing scleritis (56.4%) was the most common subtype of scleritis in this cohort followed by diffuse anterior scleritis (28.2%), nodular scleritis (12.8%). The preferred incision for phacoemulsification was clear corneal in 30 eyes (77%). In the immediate post-operative period, four eyes (10.2%) developed severe corneal edema, one eye had descemet membrane detachment. Anterior chamber reaction was observed in 18 eyes (46.1%). Fifteen eyes (38.4%) developed raised intraocular pressure and two required surgical intervention after 3 months of cataract surgery. Early posterior capsular opacification was observed in 5 eyes (12.8%) and cystoid macular edema in 2 eyes (5.1%).Conclusion: In addition to providing a distinct pattern of cataract, index study showed that long-term control of scleral inflammation prior to the cataract surgery remains the primary requisite for the successful outcome.

Keywords: Scleritis; anterior nodular scleritis; methotrexate; necrotizing scleritis; phacoemulsification.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Intraocular Pressure / physiology
  • Lens Implantation, Intraocular*
  • Male
  • Middle Aged
  • Phacoemulsification*
  • Postoperative Complications
  • Retrospective Studies
  • Scleritis / complications*
  • Scleritis / diagnosis
  • Scleritis / physiopathology
  • Slit Lamp Microscopy
  • Tonometry, Ocular
  • Visual Acuity / physiology