Persistent Anterior Uveitis Following Cataract Surgery

Abstract

Purpose: To determine the incidence of and risk factors for persistent anterior uveitis following cataract surgery. Methods: This was a retrospective cohort study of patients who underwent cataract surgery at a tertiary referral center in Connecticut, USA. Those with prior uveitis, complex ocular pathology, concurrent procedures, and surgical complications were excluded. The outcome was development of persistent anterior uveitis, defined as anterior chamber cell grade ≥ 0.5+ and steroid treatment beyond two months. Patients who did and did not develop persistent anterior uveitis were compared using univariate and multivariate analysis. Results: Of 3341 patients (5419 eyes), 45 (61) developed persistent anterior uveitis (1.1% incidence). Cases were significantly younger (64.6 years vs. 69.6 years, p < 0.001), and there were significantly higher proportions of female (73.8% compared to 58.5%, p = 0.016) and Black or African American (54.1% vs. 15.5%, p < 0.001) patients, as well as those with age-related macular degeneration (9.8% vs. 1.5%, p < 0.001), previous intravitreal injections (14.8% vs. 6.0%, p = 0.004), and diabetes (18.0% vs. 8.9%, p = 0.013). In multivariate analysis, older age was associated with a significantly lower likelihood of persistent anterior uveitis (adjusted odds ratio (AOR) = 0.963, 95% confidence interval (CI)=[0.942, 0.984]), whereas Black race (AOR = 9.102, 95% CI = [4.836, 17.133]) and wet age-related macular degeneration (AOR = 37.700, 95% CI = [6.408, 221.792]) were associated with a significantly higher likelihood. Conclusions: In this study, 1.1% of eyes developed persistent anterior uveitis following cataract surgery. Younger age, Black race, and wet age-related macular degeneration should be investigated as potential risk factors to improve its prophylaxis, identification, and management.