Cataract surgery in sympathetic ophthalmia.
OBJECTIVE
To analyze the results of cataract surgery in patients with sympathetic ophthalmia.


METHODS
Sankara Nethralaya, Medical Research Foundation, Chennai, India.


METHODS
This study comprised 66 patients (132 eyes) with sympathetic ophthalmia seen at the uveitis referral clinic between January 1990 and July 2001; 42 eyes (31.8%) had cataract. Cataract surgery was performed in 17 sympathizing eyes and 1 exciting eye (17 patients). The records of these 18 eyes were retrospectively analyzed. Three eyes had extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation, 6 eyes had ECCE without IOL implantation, and 9 eyes had phacoemulsification with IOL implantation. The mean follow-up was 28.7 months (range 3 to 60 months).


RESULTS
The causes of sympathetic ophthalmia were penetrating trauma (n = 8 eyes), ocular surgery (n = 6), perforated corneal ulcer (n = 2), and cyclocryotherapy (n = 1). The most common cataract type, present in 7 eyes (38.8%), was mixed (posterior subcapsular and posterior polar). Visual acuity improved after surgery in 13 eyes (72.2%). The main factors impairing visual recovery were submacular scar and optic atrophy, which were sequelae of the sympathetic ophthalmia. Posterior capsule opacification was noted in 14 eyes (77.7%); it was visually significant in 6 eyes. There was no significant difference in postoperative inflammation or disease reactivation between the 3 types of surgery.


CONCLUSIONS
Cataract extraction in cases of sympathetic ophthalmia can be safely and successfully performed with vigilant preoperative and postoperative control of inflammation, careful surgical planning, and meticulous surgical technique. The final visual outcome, however, depends on the posterior segment complications of the disease.
Ganesh
Sudha K
SK
Sankara Nethralaya, Medical and Vision Research Foundation, Chennai, India. ganeshsugam@yahoo.com
Sundaram
Padmaja M
PM
Biswas
Jyotirmay
J
Babu
Kalpana
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D002387:Cataract Extraction; D002648:Child; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009879:Ophthalmia, Sympathetic / Q000150:complications / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D014792:Visual Acuity