Cataract Surgery in Patients With Scleritis in the United States: An IRIS Registry (Intelligent Research in Sight) Analysis.

PURPOSE: To evaluate outcomes of and risk factors for cataract surgery in patients with scleritis.

METHODS

This retrospective cohort study evaluated demographic and ocular features of a surgical cohort of IRIS Registry (Intelligent Research in Sight) patients with scleritis undergoing cataract surgery between 2013 and 2019. Multiple logistic regression was used to identify factors associated with poor postoperative best visual acuity (BVA) in the surgical cohort and to identify risk factors for undergoing cataract surgery by comparing the surgical cohort with a nonsurgical scleritis cohort.

RESULTS

A total of 6716 eyes of 5618 patients with a preexisting scleritis diagnosis underwent cataract surgery. Average BVA improved by approximately 3 Snellen lines: mean ± SD BVA was 0.39 ± 0.43 logMAR preoperatively versus 0.12 ± 0.27 logMAR postoperatively ( P < 0.001). Postoperative complication rates were 5% for cystoid macular edema (CME), 2% for retinal detachment, and 2% for corneal edema. Preoperative CME [adjusted odds ratio (aOR) = 2.78, 95% confidence interval (CI) = 1.56-4.86] and poorer preoperative BVA (aOR = 9.10, 95% CI = 5.99-14.30) were associated with postoperative BVA >0.3 logMAR. After adjusting for age and bilaterality, female sex (aOR = 1.15, 95% CI = 1.08-1.22) and smoking (aOR = 1.63, 95% CI = 1.49-1.77) were risk factors for cataract surgery.

CONCLUSIONS

Substantial visual improvement occurs after cataract surgery in eyes with scleritis, although close observation for CME, retinal detachment, and corneal edema is warranted. Female sex and smoking are risk factors for cataract surgery in the setting of scleritis.