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Outcomes of cataract surgery in children with chronic uveitis
Karina Quiñones1, Rene A Cervantes-Castañeda, Alla Y Hynes
1Massachussets Eye Research and Surgery Institution, Cambridge, Massachusetts, USA.
Insights
Cataract surgery significantly improved vision in children with chronic uveitis. Intraocular lens implantation was well tolerated and contributed to optimal visual outcomes, even with co-occurring eye conditions.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Uveitis Management
Background:
- Chronic uveitis in children can lead to visually impairing cataracts.
- Cataract surgery outcomes in pediatric uveitis patients require careful evaluation.
Purpose of the Study:
- To assess the effectiveness of cataract surgery in improving visual acuity for children diagnosed with chronic uveitis.
Main Methods:
- Retrospective chart review of pediatric patients (<17 years) undergoing cataract surgery.
- Analysis of visual acuity outcomes, intraocular lens (IOL) implantation, and perioperative immunomodulatory therapy.
Main Results:
- Postoperative visual acuity improved in 35 of 41 eyes (85%), with a mean improvement of 3.6 lines at 1 year.
- 92% of patients improved vision after IOL implantation; 88% improved with immunomodulatory therapy.
- Cumulative probability of visual acuity improvement reached 0.91 by 1 year.
Conclusions:
- Cataract surgery is effective in enhancing visual outcomes for pediatric patients with chronic uveitis.
- Intraocular lens implantation is generally safe and beneficial in this population.
- Optimal control of intraocular inflammation is crucial for successful surgical results.
Purpose:
To evaluate the outcomes of cataract surgery in children with chronic uveitis.
Setting:
Massachusetts Eye Research and Surgery Institution, Boston, Massachusetts, USA.
Methods:
This retrospective chart review was of patients younger than 17 years with a history of uveitis who had cataract surgery before June 2004.
Results:
Thirty-four children (41 eyes) were identified. The mean age of the 10 boys and 24 girls was 9.8 years (range 4 to 17 years) and the mean total follow-up, 4.1 years (range 0.3 to 15.7 years). Twenty-one children had juvenile idiopathic arthritis-associated uveitis, 7 had pars planitis, and 6 had other conditions. Sixteen patients had concomitant posterior segment pathology, 25 received perioperative immunomodulatory therapy, and 13 had intraocular lens (IOL) implantation. The postoperative best corrected visual acuity improved in 35 of 41 eyes; 31 eyes had an improvement of 3.6 lines at 1 year. Most patients (92%) improved after IOL implantation. Most patients (88%) who received immunomodulatory therapy attained better vision, but this was not statistically significant compared with those who did not (P = .47). Similarly, there was no statistically significant difference between those with posterior pathology and those without. At the end of the analysis (1 year), the cumulative probability of improvement in visual acuity in 41 eyes reached 0.91.
Conclusion:
In most cases, and with optimum control of intraocular inflammation, cataract surgery improved the visual outcome in children with chronic uveitis. Intraocular lens implantation was well tolerated in most cases, which may result in optimal vision.
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