AAO 2026: Preventing complications in uveitic cataract surgery

Postoperative complications after cataract surgery in patients with uveitis are best prevented rather than treated, according to Anjum F. Koreishi, MD, an associate professor of ophthalmology and uveitis specialist at Northwestern University Feinberg School of Medicine in Chicago, Illinois. At the American Academy of Ophthalmology (AAO) 2026 Annual Meeting in New Orleans, Louisiana, Koreishi spoke with Ophthalmology Times about complications, patient selection, advances in uveitis treatment, and co-management.

How can complications be prevented?

Uveitis flare and macular edema are the most common complications, Koreishi said. Prevention relies on corticosteroids around the time of surgery, inflammation control for at least 3 months beforehand, and careful postoperative monitoring. Waiting longer is better when possible. When surgery must occur sooner, patients need aggressive corticosteroid treatment, but Koreishi said 3 months is “kind of the magic number where complication rates decrease.” Unlike routine cataracts, surgery in patients with uveitis should be reserved for visually significant cataracts that affect the patient.

Koreishi added that the growing use of biologic and immunomodulatory therapies borrowed from rheumatology has improved uveitis control, reducing both cataract formation and surgical complications. He now operates on fewer pediatric cataracts associated with uveitis. He attributes the decline to earlier use of adalimumab (Humira; AbbVie) and methotrexate and to avoiding corticosteroids.

When should a uveitis specialist be involved?

Access to uveitis specialists varies, Koreishi said. He co-manages many patients with comprehensive ophthalmologists who perform the surgery while he helps with perioperative management. Sometimes the support is simply a conversation about how to approach a case. A common misconception is that surgeons can operate on a quiet eye and react if uveitis flares. Koreishi receives referrals for explosive postoperative uveitis in patients who were not given corticosteroids around surgery. “So knowing these cases technically is one thing, but knowing that the postoperative course really depends on the preoperative management, and addressing that proactively, is important,” he said.

Koreishi discusses preoperative planning and surgical considerations in part 1 of this interview.

For more from the meeting, visit Ophthalmology Times’ AAO 2026 coverage.