Reactivations of ocular toxoplasmosis after cataract extraction.
OBJECTIVE
To determine the risk of reactivation of ocular toxoplasmosis following cataract extraction.


METHODS
Retrospective case-control study.


METHODS
Out of 154 patients with ocular toxoplasmosis, 14 patients (15 eyes) who had undergone a cataract extraction and 45 age- and sex- matched controls without cataract were selected.


METHODS
A review of the medical records of 14 patients with ocular toxoplasmosis and cataract and 45 control patients with ocular toxoplasmosis but without cataract. The clinical records of the controls and patients were assessed for an identical 4-month period following the date of the cataract extraction in the index patients.


METHODS
Development of a new active retinal lesion within 4 months after cataract surgery in patients and age -and sex matched-controls. The presence of risk factors such as sex, congenital or postnatal acquisition of ocular toxoplasmosis, age at first clinical manifestation of ocular toxoplasmosis, total number of attacks per affected eye, type of cataract, age at the time of cataract surgery and the intervals between surgery and first clinical manifestation of ocular toxoplasmosis and between surgery and the last recurrence of ocular toxoplasmosis, as well as the use of antiparasitic medication during surgery, type and complications of surgery and optimal visual acuity before and after cataract surgery.


RESULTS
Reactivations of ocular toxoplasmosis following cataract extraction occurred in 5/14 patients (5/15 eyes), which was higher than the incidence of recurrences in age -and sex-matched controls (p < 0.001). No additional risk factors for the development of recurrences of ocular toxoplasmosis after cataract surgery were found. Incidence of recurrences preceding surgery did not differ between patients and controls.


CONCLUSIONS
We identified an increased risk of reactivation of ocular toxoplasmosis following cataract extraction which implies that prophylactic treatment with antiparasitic drugs during and after the cataract surgery might be worthwhile for patients at risk of visual loss.
Bosch-Driessen
Lotje H
LH
FC Donders Institute of Ophthalmology, University Medical Center Utrecht, E. 03-136 Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. E.H.BoschDriessen@oogh.azu.nl
Plaisier
Marjolijn B
MB
Stilma
Jan S
JS
Van der Lelij
Allegonda
A
Rothova
Aniki
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D016022:Case-Control Studies; D002387:Cataract Extraction / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002825:Chorioretinitis / Q000469:parasitology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014122:Toxoplasma / Q000254:growth & development*; D014126:Toxoplasmosis, Ocular / Q000469:parasitology*; D014792:Visual Acuity