Cataracts in Fogt–Koyanagi–Harada syndrome: surgical treatment experience

Relevance Vogt-Koyanagi-Harada syndrome (VKH) is a rare autoimmune disease affecting melanin-containing tissues. Uveitis, which is one of the main manifestations of VKH, is often complicated by the development of cataracts, which significantly reduces vision. Surgical treatment of cataracts in VKH requires a special approach due to the risk of postoperative complications [1–5]. Aim To describe a clinical case of successful surgical treatment of cataracts in a patient with VKH. Material and methods A clinical case of a 56-year-old patient with VKH complicated by cataracts is presented. The diagnosis of VKH was made on the basis of clinical data, including bilateral panuveitis, alopecia, and poliosis. An examination was performed, including visometry, biomicroscopy, ultrasound, and OCT. Treatment included drug therapy for uveitis and phacoemulsification of cataracts with IOL implantation. Results Drug therapy resulted in remission of uveitis. After cataract phacoemulsification, visual acuity improved from hand movement near the face to 0.9–1.0 in the right eye and 0.8 in the left. IOP remained within normal limits. OCT revealed changes characteristic of SFKH, including choroidal thickening and hyperreflective foci at the level of the pigment epithelium. Conclusion Surgical treatment of cataracts in patients with SFKH is possible and effective, provided that there is adequate preoperative preparation, including relief of the inflammatory process, and careful postoperative management. Modern phacosurgical techniques minimize surgical trauma and reduce the risk of complications. Key words: Vogt-Koyanagi-Harada syndrome; cataract; phacoemulsification; uveitis; IOL