Cataract Surgery with Primary Lens Implantation in Children with Chronic Uveitis

Ocul Immunol Inflamm. 2018;26(2):298-304. doi: 10.1080/09273948.2016.1213855. Epub 2016 Sep 6.

Abstract

Purpose: To evaluate the evolution of chronic uveitis in children undergoing cataract surgery with primary intraocular lens (IOL) implantation.

Methods: Twelve children with chronic uveitis underwent cataract surgery with primary posterior chamber intraocular lens (IOL) implantation.

Results: Fourteen eyes were implanted with a foldable hydrophobic acrylic IOL. The mean follow-up was 35.39 months (8.72-69.57). The mean BCDVA before surgery and at the end of follow-up was 1.11 (0.40-2.30; SD: 0.57) and 0.48 (0-3; SD: 0.77; p=0.007) respectively. The mean oral corticosteroids dosage after surgery and at the end of follow-up was 0.80 mg/kg/day (SD: 0.37) and 0.17 mg/kg/day (SD: 0.24; p=0.001) respectively. All patients except one were treated with methotrexate. Four patients (5 eyes) were additionally treated with anti-tumor necrosis factor agent.

Conclusions: Cataract surgery with primary posterior chamber hydrophobic IOL implantation is possible and leads to a good visual recovery in cases of pediatric chronic uveitis. This surgery requires aggressive anti-inflammatory management with immunosuppressive drugs to control inflammation and reduce the corticosteroids dosage.

Keywords: Cataract surgery; hydrophilic acrylic intraocular lens; juvenile idiopathic arthritis; lens implantation; uveitis.

MeSH terms

  • Adolescent
  • Cataract / etiology
  • Cataract / therapy*
  • Child
  • Child, Preschool
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Humans
  • Lens Implantation, Intraocular / methods*
  • Male
  • Phacoemulsification*
  • Retrospective Studies
  • Uveitis / complications*
  • Visual Acuity