Combined phacovitrectomy with preoperative cyclosporin A in management of resistant panuveitis

Mohammad A RashadOphthalmology Department, Ain Shams University, Cairo, EgyptPurpose: This paper evaluates the visual outcome and report complications and uveitis control of one-stage combined pars plana vitrectomy, phacoemulsification, and intraocular lens (IOL) implantation in eyes with resistant...

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Autor principal:	Rashad MA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/d913822f899646f990d639a4430ad51a
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spelling	oai:doaj.org-article:d913822f899646f990d639a4430ad51a2021-12-02T08:43:48ZCombined phacovitrectomy with preoperative cyclosporin A in management of resistant panuveitis1177-54671177-5483https://doaj.org/article/d913822f899646f990d639a4430ad51a2012-07-01T00:00:00Zhttp://www.dovepress.com/combined-phacovitrectomy-with-preoperative-cyclosporin-a-in-management-a10389https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Mohammad A RashadOphthalmology Department, Ain Shams University, Cairo, EgyptPurpose: This paper evaluates the visual outcome and report complications and uveitis control of one-stage combined pars plana vitrectomy, phacoemulsification, and intraocular lens (IOL) implantation in eyes with resistant noninfective uveitis after preoperative control by oral cyclosporin A (CSA).Methods: This paper uses an interventional case-series study of ten eyes in nine patients with panuveitis, controlled by oral CSA with the least dose of topical and systemic steroids. All eyes underwent standard pars plana vitrectomy, microcoaxial phacoemulsification, and IOL implantation. The data recorded were visual acuity (VA), intraoperative and postoperative complications, and recurrences of activity through a minimum follow-up of 6 months.Results: The mean logarithm of the minimum angle of resolution (logMAR) significantly improved from 1.597 at baseline (3/60 Snellen&#39;s equivalent), to 0.819 at the 3-month follow-up meeting (6/45 Snellen&#39;s equivalent), to 0.663 at the 6-month postoperative visit). VA improved in 70% of eyes, worsened in 20%, and stabilized in 10%. There was improvement (.6 lines) in 30% of eyes. The rate of posterior synechia formation and uncontrollable glaucoma decreased from 60% preoperative to 10% postoperative (P = 0.01). There was significant decline in the number of eyes requiring topical steroids from 100% preoperative to 50% postoperative (P = 0.01). The same is true for oral CSA, which decreased from 100% preoperatively to 10% postoperatively.Conclusion: A single-stage combination of phacovitrectomy and IOL implantation is able to control noninfective panuveitis with less need for systemic treatment and topical steroids, and results in fewer incidence of glaucoma and posterior synechia. Furthermore, it restores useful postoperative vision.Keywords: phacovitrectomy, panuveitis, cyclosporin ARashad MADove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1083-1092 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Rashad MA Combined phacovitrectomy with preoperative cyclosporin A in management of resistant panuveitis
description	Mohammad A RashadOphthalmology Department, Ain Shams University, Cairo, EgyptPurpose: This paper evaluates the visual outcome and report complications and uveitis control of one-stage combined pars plana vitrectomy, phacoemulsification, and intraocular lens (IOL) implantation in eyes with resistant noninfective uveitis after preoperative control by oral cyclosporin A (CSA).Methods: This paper uses an interventional case-series study of ten eyes in nine patients with panuveitis, controlled by oral CSA with the least dose of topical and systemic steroids. All eyes underwent standard pars plana vitrectomy, microcoaxial phacoemulsification, and IOL implantation. The data recorded were visual acuity (VA), intraoperative and postoperative complications, and recurrences of activity through a minimum follow-up of 6 months.Results: The mean logarithm of the minimum angle of resolution (logMAR) significantly improved from 1.597 at baseline (3/60 Snellen&#39;s equivalent), to 0.819 at the 3-month follow-up meeting (6/45 Snellen&#39;s equivalent), to 0.663 at the 6-month postoperative visit). VA improved in 70% of eyes, worsened in 20%, and stabilized in 10%. There was improvement (.6 lines) in 30% of eyes. The rate of posterior synechia formation and uncontrollable glaucoma decreased from 60% preoperative to 10% postoperative (P = 0.01). There was significant decline in the number of eyes requiring topical steroids from 100% preoperative to 50% postoperative (P = 0.01). The same is true for oral CSA, which decreased from 100% preoperatively to 10% postoperatively.Conclusion: A single-stage combination of phacovitrectomy and IOL implantation is able to control noninfective panuveitis with less need for systemic treatment and topical steroids, and results in fewer incidence of glaucoma and posterior synechia. Furthermore, it restores useful postoperative vision.Keywords: phacovitrectomy, panuveitis, cyclosporin A
format	article
author	Rashad MA
author_facet	Rashad MA
author_sort	Rashad MA
title	Combined phacovitrectomy with preoperative cyclosporin A in management of resistant panuveitis
title_short	Combined phacovitrectomy with preoperative cyclosporin A in management of resistant panuveitis
title_full	Combined phacovitrectomy with preoperative cyclosporin A in management of resistant panuveitis
title_fullStr	Combined phacovitrectomy with preoperative cyclosporin A in management of resistant panuveitis
title_full_unstemmed	Combined phacovitrectomy with preoperative cyclosporin A in management of resistant panuveitis
title_sort	combined phacovitrectomy with preoperative cyclosporin a in management of resistant panuveitis
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/d913822f899646f990d639a4430ad51a
work_keys_str_mv	AT rashadma combinedphacovitrectomywithpreoperativecyclosporinainmanagementofresistantpanuveitis
_version_	1718398436864163840

Combined phacovitrectomy with preoperative cyclosporin A in management of resistant panuveitis

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