CATARACT SURGERY IN PATIENTS WITH RHEUMATOLOGICAL DISEASES

Abstract

Cataract surgery in patients with rheumatological diseases represents a clinical challenge due to the complexity and possible influence of rheumatological conditions on surgical outcome. Rheumatological diseases, such as rheumatoid arthritis, systemic lupus erythematosus and ankylosing spondylitis, can affect ocular health, increasing the risk of perioperative complications and impacting postoperative visual outcomes. Furthermore, perioperative management of these patients requires a multidisciplinary approach to optimize results. Objective: To evaluate the outcomes of cataract surgery in patients with rheumatological diseases, exploring complication rates, intervention effectiveness and factors associated with visual outcomes. Methodology: The review was carried out in accordance with PRISMA guidelines. The PubMed, Scielo and Web of Science databases were searched for articles published in the last 10 years. The descriptors used were "cataract surgery", "rheumatologic diseases", "complications", "visual outcomes" and "perioperative management". Inclusion criteria were studies that reported results of cataract surgery in patients with rheumatological diseases, written in English, Spanish or Portuguese. The exclusion criteria were studies with heterogeneous samples that did not allow specific analysis of these patients, case reports and narrative reviews. Results: A higher incidence of perioperative complications, such as cystoid macular edema and uveitis, was highlighted in patients with rheumatological diseases. However, cataract surgery was generally considered safe and effective in this population, especially when perioperative management was adequate. Factors such as control of inflammation and use of immunosuppressive therapy have been associated with better postoperative visual outcomes. Conclusion: Cataract surgery in patients with rheumatological diseases presents specific challenges, but is generally safe and effective when performed with a multidisciplinary approach and careful perioperative management. Further research is needed to fully understand the determinants of visual outcomes in this population and to optimize clinical management.