PURPOSE:To evaluate long-term outcomes of cataract surgery with primary posterior chamber intraocular lens (IOL) implantation in children with chronic uveitis.
METHODS:This retrospective analysis comprised patients younger than 16 years with chronic uveitis who underwent phacoemulsification with primary implantation of posterior chamber IOL in the capsular bag by the same surgeon. The intraocular inflammation was fully controlled for at least 3 consecutive months before surgery in all cases. The main outcome measures were the pre-surgical characteristics of risk, the difficulties and intra-surgical and post-surgical complications, the date of posterior capsulotomy (PC) and the pre- and post-surgical corrected distance visual acuity (CDVA).
RESULTS:Thirty-six eyes of 23 children (13 girls, 10 boys; median age at surgery 10.5 years old) were included. Underlying uveitic entities were juvenile idiopathic arthritis in 12 patients; idiopathic uveitis in 7; Behçet disease in 3; and varicella zoster-associated uveitis in 1 patient. The final CDVA was 0.25 logMAR or better in all cases. Postoperative complications included posterior capsule opacification requiring laser capsulotomy in 6 eyes, glaucoma in 2 eyes, and cystoid macular edema/macular dysfunction in 4 eyes. The mean dose of oral prednisone was 31.5 mg/day preoperatively and 8.16 mg/day at the last follow-up. The median follow-up was 3 years (range 1 to 5 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.