Surgical Outcomes of Contrast Sensitivity and Visual Acuity in Uveitis-Associated Cataract

Atsunobu Takeda; Eiichi Hasegawa; Shoji Notomi; Keijiro Ishikawa; Mitsuru Arima; Yusuke Murakami; Shintaro Nakao; Toshio Hisatomi; Koh-Hei Sonoda

doi:10.2147/OPTH.S314173

Surgical Outcomes of Contrast Sensitivity and Visual Acuity in Uveitis-Associated Cataract

Clin Ophthalmol. 2021 Jun 24:15:2665-2673. doi: 10.2147/OPTH.S314173. eCollection 2021.

Authors

Atsunobu Takeda^{1

2}, Eiichi Hasegawa¹, Shoji Notomi^{1

2}, Keijiro Ishikawa¹, Mitsuru Arima^{1

2}, Yusuke Murakami¹, Shintaro Nakao¹, Toshio Hisatomi³, Koh-Hei Sonoda^{1

4}

Affiliations

¹ Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
² Department of Ophthalmology, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan.
³ Department of Ophthalmology, Chikushi Hospital, Fukuoka University, Fukuoka, Japan.
⁴ Department of Ocular Pathology and Imaging Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Abstract

Purpose: To evaluate the pre- and post-operative outcomes of phacoemulsification in patients with uveitis-associated cataract in remission, such as conventional visual acuity (VA), photopic and mesopic contrast visual acuity (CVA), and flares in the anterior chamber objectively assessed as intraocular inflammation.

Patients and methods: This prospective study included 26 eyes of 19 patients with uveitis and 45 eyes of 26 controls who underwent cataract surgery at the Kyushu University Hospital and Kyushu Medical Center in Fukuoka, Japan, from October 2016 to December 2018. Conventional VA and flare values in the anterior chamber were evaluated preoperatively and 1 and 3 months postoperatively. Photopic and mesopic CVAs were assessed preoperatively and 3 months postoperatively.

Results: The best-corrected VA (BCVA) was improved significantly from baseline to 1 and 3 months postoperatively in both groups (P < 0.01 in both groups). The mean preoperative 100% and 10% CVAs under the photopic condition were significantly lower in the uveitis group than in the control group (P < 0.05 for both CVA), whereas the mean preoperative 100% CVA under the mesopic condition was comparable between the two groups. Although the mean preoperative 100% and 10% CVAs improved significantly from baseline under both photopic and mesopic conditions in both groups (P < 0.01 in both groups), the postoperative contrast sensitivities under both photopic and mesopic conditions remained lower in the uveitis group than in the control group (P < 0.01 for both conditions). The postoperative complications included recurrence of active inflammation in five eyes and cystoid macular edema in one eye and were managed by topical steroid therapy alone.

Conclusion: Cataract surgery for uveitis-associated cataracts during remission is well tolerated. However, the present results suggest that amelioration of hemeralopia and/or nyctalopia is not as good as expected after cataract surgery in patients with uveitis.

Keywords: cataract; contrast sensitivity; phacoemulsification; photopic and mesopic conditions; uveitis.

Grants and funding

This study was supported by a grant from Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number 21K09745 [grants C (A.T.)] from the Ministry of Education, Science, Sports and Culture, Japan, and grants from Novartis Pharma Research Grants (AT; Tokyo, Japan) Alcon Pharma Research Grants (AT; Tokyo, Japan). The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.