Clinical and immunological features of cataract surgery in uveitis

There is much information about successful cataract surgery for different uveitis in the literature. However, the frequency of postoperative inflammation in uveitic cataract surgery even at the present stage of microsurgery remains quite high. The aim of this study was to evaluate the clinical and immunological features of the surgical treatment of uveitic cataracts. The study group of 52 patients (74 eyes) with uveitic cataracts (male - 29, female - 23) has been chosen on the basis of the clinical material of the National Centre of Ophthalmology named after Academician Zarifa Aliyeva. The examination complex was presented by ophthalmologic and immunological methods before and after the surgery. In all patients, phacoemulsification with intraocular lens implantation was used in order to remove cataracts against the background of the disease remission and no recurrence within 3 months prior to surgery. Despite the high professional level of surgeons and careful preoperative preparation, there were minor intraoperative and postoperative complications the structure of which depended on the initial severity of the operated eyes. Shortly after the surgery inflammation of varying severity was reported in 32 eyes (43.3%) and in the late period - in 28 eyes (37.8%). In patients with developed postoperative inflammation prior to the surgery there was observed a significant increase in the average immunoregulatory index (CD4+/CD8+), complement component C3 (1753±10.01mg/L), immunoglobulin A (563.8±4.7mg/dl), immunoglobulin G (2028±7.4mg/dl) and antinuclear antibody (1.8±0.11) in serum relative to the control index (p<0.05). Careful preoperative and postoperative control of the activity of the inflammatory process, early detection of postoperative complications, complete clinical examination of the posterior segment of the eye are the key to the successful treatment of uveitic cataracts. An immunological survey before surgery may serve as an additional method of assessment to predict the risk of postoperative exudative inflammatory reaction.