Abstract
OBJECTIVES: To evaluate the current practices in uveitic cataract surgery based on expert opinions and identify areas of agreement and divergence. MATERIALS AND METHODS: A descriptive, cross-sectional expert survey was conducted among tertiary referral centers and university hospitals in Türkiye. A structured 10-item questionnaire was electronically distributed to uveitis specialists who had at least 5 years of experience in uveitis, were in active clinical practice, and managed at least 50 uveitic cataract cases per year. The questionnaire addressed preoperative preparation, intraoperative approach, and postoperative management. Multiple answers were permitted. Descriptive statistics were used for analysis. The terms "strong consensus", "consensus", and "divergence" were used to categorize levels of agreement. RESULTS: Strong consensus was observed for a 3-month inflammation-free period before surgery (85%, 17/20), continuation of conventional immunosuppressants without dose adjustment (95%, 19/20), and preference for hydrophobic acrylic intraocular lenses in uveitis associated with juvenile idiopathic arthritis (80%, 16/20). In postoperative management, 80% (16/20) tapered topical steroids within 4-6 weeks. For biologic therapies, 75% (15/20) adjusted surgical timing based on pharmacodynamic half-life. Preoperative topical steroid strategies showed divergence, with no dominant protocol. Steroid coverage strategies were practiced differentially; 65% (13/20) relied on topical steroids alone in anterior uveitis, while 60% (12/20) used intravenous steroids for posterior/panuveitis. Non-steroidal anti-inflammatory drug use for macular edema prophylaxis varied widely, and recurrence management involved systemic steroids (70%, 14/20), periocular injections (55%, 11/20), or intravitreal therapy (40%, 8/20). CONCLUSION: Expert consensus highlights standardized perioperative strategies in uveitic cataract care. However, considerable variation persists in several key areas, emphasizing the need for further research. Personalized approaches remain crucial.