When contemplating performing cataract surgery in a patient with uveitis, preoperative management is paramount. Your primary objective when treating the patient preoperatively is to control any acute inflammation, because the eye must be quiet prior to surgery. By this, they mean using simple topical medications first, followed eventually by subconjunctival injections and regional medication, and finally, if those do not work, systemic medications. In patients with severe inflammation that cannot be controlled, these physicians have even resorted to systemic immunosuppressive therapy or systemic chemotherapy. Dense posterior subcapsular cataract in a patient with uveitis and previous steroid treatment.
Preoperative management is paramount to a good surgical outcome in patients with uveitis.
Your primary objective is to control any acute inflammation so that the eye is quiet at the time of surgery. The eye should be calm for about three to four months preoperatively. Keep in mind that it is exceedingly difficult to eliminate all signs of inflammation. Patients with chronic uveitis will always have low-grade flare, but you do not want to have cells in the anterior chamber. Concern yourself with controlling active inflammation.