Cataract surgery in uveitic eyes is often challenging and can result in intraoperative and postoperative complications. Most uveitic patients enjoy good vision despite potentially sight-threatening complications, including cataract development. In those patients who develop cataracts, successful surgery stems from educated patient selection, careful surgical technique, and aggressive preoperative and postoperative control of inflammation. With improved understanding of the disease processes, pre- and perioperative control of inflammation, modern surgical techniques, availability of biocompatible intraocular lens material and design, surgical experience in performing complicated cataract surgeries, and efficient management of postoperative complications have led to much better outcome. Preoperative factors include proper patient selection and counseling and preoperative control of inflammation. Meticulous and careful cataract surgery in uveitic cataract is essential in optimizing the postoperative outcome. Management of postoperative complications, especially inflammation and glaucoma, earlier rather than later, has also contributed to improved outcomes. This manuscript is review of the existing literature and highlights the management pearls in tackling complicated cataract based on medline search of literature and experience of the authors. 1. Introduction One of the most daunting tasks for an ophthalmic surgeon is the management of complicated cataracts. Cataract in uveitis may develop as a result of the intraocular inflammation per se, from chronic corticosteroid usage or more often from both [1]. The incidence of cataract in uveitis varies from 57% in pars planitis [2] to 78% in Fuchs heterochromic iridocyclitis (FHI) [3]. Cataract surgery in uveitic eyes is challenging and can present with many unforeseen intraoperative complications. Two decades ago, the outcome of surgery in these eyes was guarded and often confounded by postoperative complications such as severe inflammation, hypotony, and even phthisis bulbi. However, with modern day cataract surgical techniques, this is seldom the case. With improved understanding of disease processes, optimization of immunosuppression for perioperative control of inflammation, minimally invasive surgical techniques, availability of biocompatible intraocular lens material and design and surgeons trained in performing complicated cataract surgeries and anticipatory management of postoperative complications [4], the outcome has been maximized. Ocular morbidity in patients undergoing complicated cataract surgery
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