Journal of cataract and refractive surgery · 2011
Cataract surgery with primary intraocular lens implantation in children with uveitis: long-term outcomes.
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Terrada Celine, Julian Karina, Cassoux Nathalie, Prieur Anne-Marie, Debre Marianne, Quartier Pierre, LeHoang Phuc, Bodaghi Bahram
Аннотация
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.
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.
Предметные рубрики MeSH
AdolescentCapsule OpacificationChildChild, PreschoolChronic DiseaseCoated Materials, BiocompatibleFemaleFollow-Up StudiesGlucocorticoidsHeparinHumansIntraoperative ComplicationsLaser TherapyLasers, Solid-StateLens Implantation, IntraocularLenses, IntraocularMalePhacoemulsificationPolymethyl MethacrylatePostoperative ComplicationsTreatment OutcomeUveitis