Posterior capsular opacification after cataract surgery in uveitis

Purpose Posterior capsular opacification (PCO) is commoner in uveitic eyes, yet the reasons for this are not fully understood. This study determines the incidence of PCO and Nd:YAG laser posterior capsulotomy after cataract surgery and implantation of a particular acrylic intraocular lens (IOL) in patients with uveitis, and identifies associated risk factors. Methods A retrospective case series of patients with various types of uveitis, and a consecutive cohort of patients with age‐related cataract (controls) all undergoing phakoemulsification cataract surgery and implantation of a Rayner acrylic, hydrophilic IOL. Patients were identified from theatre and laser records. Patients from both cohorts were followed up for 2 years. Results After 2 years, of the 219 control eyes identified only 4 (1.8%) had Nd:YAG capsulotomies performed. In the uveitis group, PCO occurred in 61 of 132 eyes (46.2%). Panuveitis was the commonest type of uveitis associated with the development of PCO (50.6%), and sarcoidosis (7/13 eyes, 53.8%), and Fuchs’ heterochromic cyclitis (7/16 eyes, 43.8%) were the most frequently associated conditions. The use of iris retractors or synechiolysis was not associated with PCO. Nd:YAG capsulotomy was required in only 10 of the 61 uveitic eyes (16.4%) with PCO. Conclusion The Rayner acrylic, hydrophilic IOL appears to have a very low Nd:YAG rate after 2 years in patients having undergone uncomplicated phakoemulsification for age‐related cataract. Although almost 50% of uveitic eyes after 2 years developed PCO with this IOL, in the majority of those eyes it did not result in significant visual impairment as only 10 eyes required Nd:YAG capsulotomy.