Optimal timing for cataract surgery in patients with thyroid-associated ophthalmopathy

AIM: To investigate the optimal timing and therapeutic effects of cataract surgery in patients with moderate to severe thyroid-associated ophthalmopathy (TAO). METHODS: Data from TAO patients who underwent cataract surgery between 2014 and 2024 were analyzed. patients were categorized into two group...

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Main Authors: Na Miao, Yan-Chi Chen, Wei-Min He
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2025-04-01
Series:International Journal of Ophthalmology
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Online Access:http://ies.ijo.cn/en_publish/2025/4/20250406.pdf
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author Na Miao
Yan-Chi Chen
Wei-Min He
author_facet Na Miao
Yan-Chi Chen
Wei-Min He
author_sort Na Miao
collection DOAJ
description AIM: To investigate the optimal timing and therapeutic effects of cataract surgery in patients with moderate to severe thyroid-associated ophthalmopathy (TAO). METHODS: Data from TAO patients who underwent cataract surgery between 2014 and 2024 were analyzed. patients were categorized into two groups based on the hospital where their cataract surgery was performed: an external hospital surgery group and an in-house hospital surgery group. Patients in external hospital presenting with complications within six months postoperatively were assessed for clinical features, imaging, thyroid function, and outcomes. Patients who underwent surgery at West China Hospital were evaluated for clinical status, imaging, laboratory findings, and manifestations. RESULTS: In the external hospital group (n=31), common symptoms included eyelid swelling (64.52%) and diplopia (51.61%), with restricted eye movement in all patients. Most patients were in the active stage (87.10%) and exhibited various complications, such as dysthyroid optic neuropathy (DON) in 4 patients, misdiagnosis of glaucoma in 1 patient, and enucleation due to fungal infection in 1 patient. In the West China Hospital group (n=30), 2 patients were in the active stage, and 28 were in the inactive stage. Postoperative visual acuity improved in 36 eyes, except for in 2 eyes with DON. Active TAO patients with mature cataracts had effective inflammation control and no complications at the 6-month follow-up. CONCLUSION: In patients with moderate to severe active TAO complicated by cataracts, delaying cataract surgery until 6mo of TAO control should be considered if cataracts are stable. Simultaneous anti-inflammatory treatment and cataract surgery should be performed for mature/hypermature cataracts, and TAO management should be continued after surgery.
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spelling doaj-art-5175ebdc8e2a4e01a8d03d35780828262025-08-20T02:50:40ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982025-04-0118460661410.18240/ijo.2025.04.0620250406Optimal timing for cataract surgery in patients with thyroid-associated ophthalmopathyNa Miao0Yan-Chi Chen1Wei-Min He2Wei-Min He. Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China. hewm888@hotmail.comThe First People's Hospital of Yibin, Yibin 644000, Sichuan Province, ChinaDepartment of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, ChinaAIM: To investigate the optimal timing and therapeutic effects of cataract surgery in patients with moderate to severe thyroid-associated ophthalmopathy (TAO). METHODS: Data from TAO patients who underwent cataract surgery between 2014 and 2024 were analyzed. patients were categorized into two groups based on the hospital where their cataract surgery was performed: an external hospital surgery group and an in-house hospital surgery group. Patients in external hospital presenting with complications within six months postoperatively were assessed for clinical features, imaging, thyroid function, and outcomes. Patients who underwent surgery at West China Hospital were evaluated for clinical status, imaging, laboratory findings, and manifestations. RESULTS: In the external hospital group (n=31), common symptoms included eyelid swelling (64.52%) and diplopia (51.61%), with restricted eye movement in all patients. Most patients were in the active stage (87.10%) and exhibited various complications, such as dysthyroid optic neuropathy (DON) in 4 patients, misdiagnosis of glaucoma in 1 patient, and enucleation due to fungal infection in 1 patient. In the West China Hospital group (n=30), 2 patients were in the active stage, and 28 were in the inactive stage. Postoperative visual acuity improved in 36 eyes, except for in 2 eyes with DON. Active TAO patients with mature cataracts had effective inflammation control and no complications at the 6-month follow-up. CONCLUSION: In patients with moderate to severe active TAO complicated by cataracts, delaying cataract surgery until 6mo of TAO control should be considered if cataracts are stable. Simultaneous anti-inflammatory treatment and cataract surgery should be performed for mature/hypermature cataracts, and TAO management should be continued after surgery.http://ies.ijo.cn/en_publish/2025/4/20250406.pdfthyroid-associated ophthalmopathycataract surgerysurgical timing
spellingShingle Na Miao
Yan-Chi Chen
Wei-Min He
Optimal timing for cataract surgery in patients with thyroid-associated ophthalmopathy
International Journal of Ophthalmology
thyroid-associated ophthalmopathy
cataract surgery
surgical timing
title Optimal timing for cataract surgery in patients with thyroid-associated ophthalmopathy
title_full Optimal timing for cataract surgery in patients with thyroid-associated ophthalmopathy
title_fullStr Optimal timing for cataract surgery in patients with thyroid-associated ophthalmopathy
title_full_unstemmed Optimal timing for cataract surgery in patients with thyroid-associated ophthalmopathy
title_short Optimal timing for cataract surgery in patients with thyroid-associated ophthalmopathy
title_sort optimal timing for cataract surgery in patients with thyroid associated ophthalmopathy
topic thyroid-associated ophthalmopathy
cataract surgery
surgical timing
url http://ies.ijo.cn/en_publish/2025/4/20250406.pdf
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