Visual outcome and prognostic factors in cataract surgery in ocular tuberculosis.

PURPOSE: To analyze the outcome of cataract surgery in patients with ocular tuberculosis (OTB).

METHODS

Medical records of patients with OTB who underwent cataract surgery between 2005 and 2018 were retrospectively reviewed. The primary outcome measure was corrected distant visual acuity (CDVA), and a good outcome was defined as CDVA 20/40 or better.

RESULTS

There were 35 patients (41 eyes), of whom 13 (37.1%) were males and 22 (62.9%) were females. The mean age was 41.6 ± 13.8 (range 18-65) years. Anterior uveitis was present in 24 (58.5%) eyes, intermediate uveitis in 5 (12.2%) eyes, posterior uveitis in 6 (14.6%) eyes, and panuveitis in 6 (14.6%) eyes. Posterior sub-capsular cataract (51.2%) was the most common type of cataract. Total cataract was present in 9 (22%) eyes. The two most common ocular comorbidities were small pupil (85.4%) and glaucoma (17.1%). Phacoemulsification was performed in 36 (87.8%) eyes and ECCE was performed in 5 (12.2%) eyes. Intraoperatively the pupil was mechanically dilated in 36 (87.8%) eyes. Overall 26 (63.4%) and 23 (56.1%) eyes achieved CDVA 20/40 or better at 1- and 6-month follow-up visit, respectively. The mean preoperative LogMAR CDVA significantly improved from 1.28 ± 0.57 to 0.38 ± 0.36 at 1-month (P < 0.0001). One eye had fibrinous anterior chamber reaction and 24 (58.5%) eyes had 1 or more episodes of reactivation of uveitis in the follow-up period. The three commonest complications were glaucoma (26.8%), posterior capsule opacification (19.5%), and epiretinal membrane (17.1%). Postoperative posterior segment complications like epiretinal membrane formation, vitreous inflammation and cystoid macular edema affected final visual acuity (P < 0.002).

CONCLUSION

The visual outcome after cataract surgery in OTB was satisfactory as significant number of patients achieved a good final visual acuity.