Safety and efficacy of dexamethasone implant along with phacoemulsification and intraocular lens implantation in children with juvenile idiopathic arthritis associated uveitis

Indian J Ophthalmol. 2019 Jan;67(1):69-74. doi: 10.4103/ijo.IJO_713_18.

Abstract

Purpose: To assess the safety and efficacy of intraoperative intravitreal dexamethasone implant in patients of juvenile idiopathic arthritis (JIA)-associated uveitis undergoing phacoemulsification with posterior chamber intraocular lens (PCIOL) implantation.

Methods: Retrospectively, data of patients with JIA-associated uveitis undergoing phacoemulsification with PCIOL implantation with intraoperative dexamethasone implant injection were analyzed. Patients with a minimum follow-up of 6 months were included. Primary outcome measures were ocular inflammation, intraocular pressure (IOP), best-corrected visual acuity (BCVA), and worsening of uveitis.

Results: 8 eyes of 6 patients were included. BCVA was significantly improved at 1, 3, and 6 months postoperatively 0.20 ± 0.09, P = 0.008; 0.18 ± 0.11, P = 0.008; and 0.24 ± 0.11, P = 0.01, respectively. No statistical difference noted in mean IOP at various follow-up visits. None developed worsening of uveitis or Cystoid macular edema.

Conclusion: Intraoperative intravitreal dexamethasone implant is a safe and effective in preventing and managing the postoperative inflammation in children with JIA-associated uveitic cataract.

Keywords: Children; JIA; cataract surgery; dexamethasone implant; juvenile idiopathic arthritis; phacoemulsification; uveitis.

MeSH terms

  • Arthritis, Juvenile / complications*
  • Arthritis, Juvenile / diagnosis
  • Cataract / complications*
  • Child
  • Dexamethasone / administration & dosage*
  • Drug Implants
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Humans
  • Intraocular Pressure
  • Intraoperative Period
  • Intravitreal Injections
  • Lens Implantation, Intraocular / methods*
  • Male
  • Phacoemulsification / methods*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Uveitis / diagnosis
  • Uveitis / etiology*
  • Visual Acuity*

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone