Steroid prophylaxis in eyes with uveitis undergoing phacoemulsification.
OBJECTIVE
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.


CONCLUSIONS
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.
Tremona Road, Eye Unit, Southampton General Hospital, Southampton, Hants, UK. wmeacock@hotmail.com
W R
WR
Meacock
D J
DJ
Spalton
L
L
Bender
R
R
Antcliff
C
C
Heatley
M R
MR
Stanford
E M
EM
Graham
D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D018916:Blood-Aqueous Barrier / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D008269:Macular Edema / Q000209:etiology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011239:Prednisolone / Q000008:administration & dosage*; D011300:Preoperative Care; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy*; D014792:Visual Acuity / Q000502:physiology
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011239:Prednisolone; D008775:Methylprednisolone