Outcomes of acute postoperative inflammation after cataract surgery

PURPOSE: To determine characteristics and final visual and surgical outcomes of patients who experienced early onset postoperative inflammation after cataract surgery and their early and late complications. METHODS: This is a prospective case series of 126 patients out of 1500 cases who underwent cataract surgery and experienced early onset postoperative inflammation during the first 2 weeks after cataract surgery. All the patients received complete ocular examinations at onset of signs and symptoms of inflammation. A total of 110 patients with follow-up examinations between 3 and 30 months after recovery of early onset postoperative inflammation (mean follow-up 11.6 months) were enrolled in the next part of the study to evaluate the final visual and surgical outcomes. Background systemic and ocular diseases, type of surgery, type of intraocular lenses and viscoelastic agent, early and late complications, and final best-corrected visual acuity were studied. RESULTS: Among 1500 patients, 126 cases (8.4%) had early onset postoperative inflammation, 64 cases (50.7%) were male, and 62 cases (49.3%) were female. Early complications were posterior synechia in 9 cases (7.1%), pupillary block in 2 cases (1.5%), and acute rise of intraocular pressure in 6 cases (4.7%). Late complications consisted of posterior capsular opacity in 38 cases (34.5%) and cystoid macular edema in 4 cases (3.2%). Peak of signs and symptoms of inflammation was during 2 weeks after surgery and all patients responded well to topical steroids. Final best-corrected visual acuity (BCVA) was 20/30 and better in 76 cases (69%), between 20/40 and 20/80 in 24 cases (22%), and less than 20/80 in 10 cases (9%). All cases with BCVA less than 20/80 had ocular diseases like choroidal neovascularization scar or age-related macular degeneration, advanced glaucoma, or corneal opacity. CONCLUSIONS: Early onset postoperative inflammation causes pain, decreased vision, and patient anxiety in the acute phase but neither decreases final visual acuity nor has any significant or permanent ocular sequels.