Objective: To explore the efficacy of operation on children's complicated cataract induced by uveitis and discuss the therapeutic methods in perioperative period and the influencing factor of effect in treatment.
Method: Retrospective case series study. Thirteen cases (17 eyes) children's complicated cataract induced by uveitis who were treated by phacoemulsification with intraocular lens implantation in Peking union medical college hospital from Feb.2002 to Dec.2011 were collected. The characteristics, perioperative medical managements, surgical approach, postoperative visual, complications and follow-up states postoperatively were observed.
Result: Total of 13 cases (17 eyes) of children uveitis, which including 4 cases (4 eyes) of male, 9 cases (13 eyes) of female, and 1 (1 eye) Reiter's symptom and 2 (3 eyes) juvenile idiopathic arthritis (JIA) were collected. The average operative age was (9.6 ± 2.4) years. The average time of inflammation fully controlled was (6.44 ± 5.88) months. All 17 eyes were received phacoemulsification with intraocular lens implantation, among them 12 eyes were received pupil forming meanwhile. Prednisolone 0.8-1.0 mg × kg⁻¹ × d⁻¹ was used 3 days pre-operatively or on the operation day, 6 serious patients were given additional systemic immunosuppressive treatments. All patients were followed up from 8-72 months; the average follow-up time was (36.4 ± 19.8) months. The average using time of prednisolone was (5.4 ± 6.5) months. At the final point, 14 eyes got the best corrected visual acuity (BCVA) of 0.3 or better. Among those, 12 eyes BCVA were 0.6 or better. All BCVA were improved significantly compared with pre-operative which was lower than 0.3. During the follow up periods, Neodymium: YAG (Nd:YAG) laser posterior capsulotomy was performed in 14 eyes because of the posterior capsular opacity (PCO). Other postoperative complications were seen as macular edema (3 eyes), uveitis recurrence (9 eyes), secondary glaucoma (5 eyes) and IOL reduction (2 eyes).
Conclusions: The method of phacoemulsification with intraocular lens on children's complicated cataract induced by uveitis could improve the visual acuity effectively. The opportunity of the operation, properly medical applications perioperatively and follow-up postoperatively was crucial for a successful operation.