Outcomes of Cataract Surgery and IOL Implantation in Anterior Uveitis

Background: Cataract formation is one of the most common complications of anterior uveitis. Cataract extraction in these patients poses a heightened risk of intraoperative and postoperative complications. Despite the advances in surgical methods and perioperative management strategies, recurrence of inflammation and poor clinical outcomes persist. Objective: To evaluate preoperative conditions, postoperative visual and clinical results, and complications of cataract surgery in patients with anterior uveitis in Pakistan. Methods: A prospective observational cohort study was conducted at LRBT Tertiary Teaching Eye Hospital from June 2023 to May 2024, including 65 patients with cataracts secondary to anterior uveitis. Patients were classified into four groups: (i) Idiopathic, (ii) Fuchs' heterochromic iridocyclitis, (iii) Infective anterior uveitis and (iv) non-infectious anterior uveitis. Preoperative evaluation included visual acuity assessment, slit-lamp examination, intraocular pressure measurement, and OCT when indicated. All patients underwent phacoemulsification with intraocular lens implantation. Postoperative outcomes, including best-corrected visual acuity (BCVA). Anterior chamber cells, flare and other complications were assessed at 1 week, 1 month, and 6 months. Data were analysed using SPSS version 25. Results: Fuchs uveitis showed the most favourable and most sustained BCVA improvement. Non-infectious and idiopathic cases showed moderate gains, while infective anterior uveitis had the poorest outcomes. Complications included posterior capsular opacification (40%), cystoid macular edema (27.7%), and recurrent uveitis (12.3%). Intraocular pressure fluctuated but significantly decreased at six months (p < 0.001). Conclusion: Perioperative inflammation control is critical for favourable visual outcomes in uveitic cataract surgery. Optimised surgical strategies and meticulous postoperative care are crucial for improving outcomes and reducing complications in patients with anterior uveitis.