Incidence of Postoperative Uveitis Following Cataract Surgery in Patients from the National Rehabilitation Institute

Abstract

Introduction
Cataract surgery is the most common ophthalmologic procedure performed at the National Rehabilitation Institute (INR), with high levels of visual efficacy. However, it is not exempt from complications such as postoperative uveitis, whose incidence and etiology have been scarcely described in Mexican literature, limiting preventive and therapeutic strategies.

Objective
To determine the incidence of postoperative uveitis following cataract surgery in patients treated at the INR and to explore the associated clinical, surgical, and etiological factors.

Methodology
An observational, retrospective, and descriptive study was conducted through the review of medical records from 2022 to 2024. Patients aged ≥18 years who underwent cataract surgery without combined intraocular procedures were included. Postoperative uveitis (defined as ≥1+ cell in the anterior chamber after 4 weeks) was analyzed, and associated variables were identified. Bivariate analysis and logistic regression were used to assess prognostic factors.

Results
A total of 46 uveitis cases were identified among 3,449 cataract surgeries (incidence: 1.33%). Systemic comorbidities other than type 2 diabetes mellitus or hypertension were present in 41.3% of cases (OR 15.4, p<0.001). Surgeries performed by attending physicians (50% vs. 10.9%, OR 8.2, p<0.001), history of ocular surgery (OR 4.8, p=0.003), and manual techniques (ECCE/MSICS, OR 2.9, p=0.07) were associated with higher risk. Additionally, 19.6% of patients had a history of uveitis. The etiological agent was identified in 82.6% of cases: Mycobacterium tuberculosis (16.3%), Treponema pallidum (9.8%), and herpes virus (4.3%) were the most common; non-infectious causes included retained lens fragments and UGH syndrome. In 17.4% of cases, the etiology could not be determined.

Conclusions
The incidence of postoperative uveitis at the INR is low but clinically significant. It is mainly associated with systemic comorbidities, previous ocular surgeries, manual techniques, and surgeries performed by attending physicians—potentially reflecting higher surgical complexity. An etiological diagnosis was achieved in most cases, with infectious causes such as tuberculosis and syphilis predominating. These findings highlight the importance of a comprehensive and context-specific diagnostic approach, particularly in national referral hospitals.

Keywords:
Cataract surgery; postoperative uveitis; intraocular inflammation; complications; ophthalmology