Favourable outcome after cataract surgery with IOL implantation in uveitis associated with juvenile idiopathic arthritis.
Summary of "Favourable outcome after cataract surgery with IOL implantation in uveitis associated with juvenile idiopathic arthritis."
Purpose:â€‚ Management of uveitic cataract in patients with juvenile idiopathic arthritis (JIA) is challenging, and intraocular lens (IOL) implantation is controversial. This study investigated the outcome after minimally invasive surgery with IOL implantation. Methods:â€‚ Retrospective analysis after phacoemulsification with in-the-bag IOL implantation was performed in 16 patients (17 operations) with ANA-positive JIA-associated chronic uveitis. In these patients, 25â€ƒG capsulectomy and anterior vitrectomy was performed and they received an intravitreal triamcinolone (TA) injection. Results:â€‚ Mean age at uveitis onset was 5â€ƒÂ±â€ƒ2â€ƒyears, and surgery was performed at a mean age of 11â€ƒÂ±â€ƒ2.2â€ƒyears. Preoperatively, uveitis was inactive in all patients, and visual acuity was logMAR 0.8â€ƒÂ±â€ƒ0.44; additional uveitis complications were present in all patients, and 15 patients were receiving systemic immunosuppression/biologicals. After surgery (mean follow-up 26.5â€ƒÂ±â€ƒ11.7â€ƒmonths), presence of cystoid macular oedema, papilloedema, ocular hypertension/glaucoma and hypotony did not increase compared with baseline. There was no significant worsening of AC inflammation (by cell numbers and laser flare values). IOL deposits persisted in four patients, and synechiae developed in eight. The visual acuity was improved (â‰¥2 lines) in all patients (mean logMAR 0.3â€ƒÂ±â€ƒ0.24). Retrolental membrane formation was not noted. Secondary capsular opacification was observed in seven patients, requiring Nd:YAG capsulotomy in five of them. Conclusions:â€‚ Phacoemulsification and in-the-bag IOL implantation may improve visual outcome in JIA-associated uveitis with minimally invasive surgical technique and intravitreal TA injection. Well-controlled uveitis with appropriate use of topical steroids and systemic immunosuppression or biologicals appears as a perioperative requirement.
Department of Ophthalmology, University of Cologne, Cologne, Germany Department of Ophthalmology, St Franziskus Hospital Muenster, University of Duisburg-Essen, Muenster, Germany.
This article was published in the following journal.
Name: Acta ophthalmologica
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21310018
- DOI: http://dx.doi.org/10.1111/j.1755-3768.2011.02110.x
Medical and Biotech [MESH] Definitions
Corneal Endothelial Cell Loss
Loss of CORNEAL ENDOTHELIUM usually following intraocular surgery (e.g., cataract surgery) or due to FUCHS' ENDOTHELIAL DYSTROPHY; ANGLE-CLOSURE GLAUCOMA; IRITIS; or aging.
Lens Implantation, Intraocular
Insertion of an artificial lens to replace the natural CRYSTALLINE LENS after CATARACT EXTRACTION or to supplement the natural lens which is left in place.
The making of a continuous circular tear in the anterior capsule during cataract surgery in order to allow expression or phacoemulsification of the nucleus of the lens. (Dorland, 28th ed)
Partial or complete opacity on or in the lens or capsule of one or both eyes, impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). (Dorland, 27th ed)
Human histocompatibility (HLA) surface antigen encoded by the B locus on chromosome 6. It is strongly associated with acute anterior uveitis (UVEITIS, ANTERIOR); ANKYLOSING SPONDYLITIS; and REACTIVE ARTHRITIS.
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