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

J Cataract Refract Surg. 2011 Nov;37(11):1977-83. doi: 10.1016/j.jcrs.2011.05.037. Epub 2011 Sep 22.

Abstract

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.

MeSH terms

  • Adolescent
  • 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 Implantation, Intraocular*
  • Lenses, Intraocular
  • Male
  • Phacoemulsification*
  • Polymethyl Methacrylate
  • Postoperative Complications
  • Treatment Outcome
  • Uveitis / complications*
  • Uveitis / drug therapy

Substances

  • Coated Materials, Biocompatible
  • Glucocorticoids
  • Heparin
  • Polymethyl Methacrylate