Cataract surgery with primary intraocular lens implantation in children with uveitis: Long-term outcomes

• Published in: Journal of cataract and refractive surgery Vol. 37; no. 11; pp. 1977 - 1983
• Main Authors: Terrada, Celine, MD, PhD, Julian, Karina, MD, Cassoux, Nathalie, MD, PhD, Prieur, Anne-Marie, MD, Debre, Marianne, MD, Quartier, Pierre, MD, PhD, LeHoang, Phuc, MD, PhD, Bodaghi, Bahram, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2011; Elsevier
• Subjects: Adolescent; Biological and medical sciences; Capsule Opacification - etiology; Capsule Opacification - surgery; Child; Child, Preschool; Chronic Disease; Coated Materials, Biocompatible; Female; Follow-Up Studies; Glucocorticoids - administration & dosage; Heparin; Humans; Intraoperative Complications; Laser Therapy; Lasers, Solid-State; Lens diseases; Lens Implantation, Intraocular; Lenses, Intraocular; Male; Medical sciences; Ophthalmology; Phacoemulsification; Polymethyl Methacrylate; Postoperative Complications; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Treatment Outcome; Uvea diseases; Uveitis - complications; Uveitis - drug therapy; Human; Cataract; Prognosis; Implantation; Uvea disease; Long term; Eye disease; Lens disease; Treatment; Surgery; Primary; Uveitis; Evolution; Ophthalmology; Intraocular lens; Child; Anterior segment disease
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2011.05.037

Purpose To report long-term outcomes of cataract surgery with primary posterior chamber intraocular lens (IOL) implantation in children with chronic uveitis. Setting Department of Ophthalmology, Pitié-Salpêtrière Hospital, Paris, France. Design Case series. Methods This case series comprised patients younger than 16 years with chronic uveitis who underwent phacoemulsification with primary implantation of a heparin surface-modified poly(methyl methacrylate) posterior chamber IOL in the capsular bag. The intraocular inflammation was fully controlled for at least 3 consecutive months before surgery in all cases. The main outcome measures were final corrected distance visual acuity (CDVA), postoperative inflammation, complications, and level of immunosuppressive treatment. Results Twenty-two eyes of 16 children (7 girls, 9 boys; median age at surgery 9.5 years old) were included. Underlying uveitic entities were juvenile idiopathic arthritis in 9 patients; idiopathic uveitis in 4; and Behçet disease, sarcoidosis, and varicella zoster-associated uveitis in 1 patient each. The final CDVA was 0.3 logMAR or better in all cases. Postoperative complications included posterior capsule opacification requiring laser capsulotomy in 2 eyes, glaucoma in 4 eyes, and cystoid macular edema/macular dysfunction in 3 eyes. The mean dose of oral prednisone was 29.5 mg/day preoperatively and 8.13 mg/day at the last follow-up. The median follow-up was 6 years (range 5 to 19 years). Conclusion The results indicate that uveitis is not a formal contraindication to primary IOL implantation in the management of pediatric cataract surgery in cases with full control of intraocular inflammation. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.