The Association of Uveitis with Prior Ocular Surgeries: A Within-Person Matched Case-Control Study.

PURPOSE: To determine if ocular procedures are a risk factor for uveitis in patients without systemic autoimmune disease. METHODS: We performed a retrospective within-person matched case-control study for patients with unilateral uveitis from 2015 to 2020 on the United States Medicare-covered healthcare claims data. We determined the fellow non-uveitic eye as the control, and excluded patients with endophthalmitis, a history of autoimmune disease and uveitis within 3 months after surgery. We reviewed incisional surgeries, laser procedures, and intravitreal injections, and calculated matched odds ratios for prior ocular procedures in uveitic versus fellow control eyes using McNemar's test. RESULTS: 565 patients were included. Uveitic eyes had significantly higher odds of prior ocular procedures compared with fellow control eyes (matched OR, 1.9; 95% CI, 1.3-2.9). We observed higher odds for incisional surgeries (OR 2.0; 1.3-3.1), laser procedures (OR 2.4; 1.04-5.4), and intravitreal injections (OR 4.8; 1.6-14.0). The difference was significant for complex cataract surgery (OR 3.3; 1.3-8.3), corneal surgery (OR 4.0; 1.1-14.2), glaucoma surgery (OR 3.8; 1.4-10.2), and pars plana vitrectomy (OR 4.6; 2.0-10.4), but not for routine cataract surgery (OR 1.0; 0.6-1.8). CONCLUSION: Our findings suggest that prior ocular procedures may be a risk factor for uveitis. These findings shed light on the etiology of some "idiopathic" uveitis cases in patients with prior ocular surgery.