title: Perioperative prophylaxis to prevent recurrence following cataract surgery in uveitic patients: a two-centre, prospective, randomized trial.
abstract: OBJECTIVE
  To compare the postoperative risk of inflammatory relapse in two groups of uveitic patients who underwent cataract surgery: one group had perioperative topical steroids alone and the other used topical and oral steroids.
  
  
  METHODS
  Prospective, randomized, unmasked, duocentric clinical trial conducted at the University of Parma (Italy), and the Jules Gonin Eye Hospital of Lausanne (Switzerland). Patients with a history of non-infectious uveitis requiring cataract surgery in 2009-2013 were assigned to two groups of perioperative prophylaxis: (A) intensive topical steroids alone; (B) the same topical regimen combined with oral steroids. Uveitis relapse over a period of 6 months was assessed.
  
  
  RESULTS
  In total, 52 eyes in 50 patients were randomized: 28 eyes were assigned to group A (topical) and 24 eyes to group B (topical + oral). Mean relapse-free survival time was 131 ± 11 days in group A and 150 ± 13 days in group B. This difference was not statistically significant (p = 0.42). At the end of follow-up, the groups were also comparable in terms of significant improvement in visual acuity (p < 0.01), mean central macular thickness (CMT) and IOP variation.
  
  
  CONCLUSIONS
  Absolute and long-lasting control of ocular, and possibly systemic, inflammation predisposes uveitis patients to satisfactory results after cataract extraction and intraocular lens implantation. Despite a lower rate of recurrences following oral steroid supplementation, the efficacy of an intensive perioperative topical steroid regimen alone in preventing postoperative uveitis relapse was statistically comparable. Secondary outcomes were also comparable between the two groups. Transient IOP elevation should be expected until treatment discontinuation.
authors: Institute of Ophthalmology, University Hospital of Parma, Parma, Italy.
authors: Paolo
authors: P
authors: Mora
authors: Institute of Ophthalmology, University Hospital of Parma, Parma, Italy.
authors: Stefania
authors: S
authors: Gonzales
authors: Institute of Ophthalmology, University Hospital of Parma, Parma, Italy.
authors: Stella
authors: S
authors: Ghirardini
authors: Institute of Ophthalmology, University Hospital of Parma, Parma, Italy.
authors: Pierangela
authors: P
authors: Rubino
authors: Institute of Ophthalmology, University Hospital of Parma, Parma, Italy.
authors: Jelka G
authors: JG
authors: Orsoni
authors: Institute of Ophthalmology, University Hospital of Parma, Parma, Italy.
authors: Stefano A
authors: SA
authors: Gandolfi
authors: Department of Ophthalmology, Jules-Gonin Eye Hospital, University of Lausanne, Lausanne, Vaud, Switzerland.
authors: Francois
authors: F
authors: Majo
authors: Department of Ophthalmology, Jules-Gonin Eye Hospital, University of Lausanne, Lausanne, Vaud, Switzerland.
authors: Yan
authors: Y
authors: Guex-Crosier
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D019990:Perioperative Care; D018918:Phacoemulsification; D011446:Prospective Studies; D012008:Recurrence; D012160:Retina / Q000473:pathology; D014605:Uveitis / Q000517:prevention & control*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D003907:Dexamethasone
keywords: cataract surgery; prophylaxis; recurrence; uveitis