Long-Term Outcome of Cataract Extraction and Intraocular Lens Implantation in Fuchs' Heterochromic Iridocyclitis

Purpose: To investigate long-term visual outcome and complications after cataract extraction and intraocular lens (IOL) implantation in Fuchs' heterochromic iridocyclitis (FHI) Methods: In this retrospective study in a private eye clinic in Tehran, 25 eyes of 24 patients with FHI who underwent cataract extraction and IOL implantation were evaluated based on their visual outcome and intraoperative and postoperative complications. Results: Cataract extraction was performed on 12 men and 13 women between 19 to 62 years old (mean 39.4 +/- 10.3 years) with 102.20 +/- 45.54 months (range, 61-200 months) follow-up. Mean visual acuity (VA) improved from 1.26 +/- 0.57 log MAR (less than 20/200) before surgery to 0.08 +/- 0.22 log MAR (more than 20/25) at the last follow-up (P<0.001). Fifteen eyes (60%) achieved VA >= 20/20. Mean intraocular pressure (IOP) in the last follow-up was slightly lower than preoperation but was not statistically significant (P=0.42). Glaucoma was found in 2 (8%) cases before surgery and 3 more cases (12%) were diagnosed along the postoperative follow-up. Severe postoperative inflammation with hypopion and fibrin formation occurred in 2 (8%) cases and severe recurrent intraocular inflammatory episodes appeared in 4 (16%) cases during the follow-up. YAG laser capsulotomy was done in 7 (28%) cases were developed posterior capsular opacity. Conclusion: Long-term visual outcome after cataract extraction and IOL implantation in patients with FHI are satisfactory. However, possible inflammatory crisis and glaucoma necessitate intensive care and regular postoperative long-term follow-up of these patients.