Skip to main content
SpringerLink
Log in

Cataract Surgery in Childhood Uveitis

  • Chapter
Surgical Management of Inflammatory Eye Disease

  • 857 Accesses

Abstract

■ Cataract formation is a frequent complication in childhood uveitis.

■ Management of cataract in childhood uveitis is particularly difficult.

■ Patient selection is important for successful surgery.

■ Steroid-sparing immunosuppression may decrease the incidence of cataract.

■ Preoperative evaluation is required in order to specify the course and etiology of uveitis.

■ Complete quiescence of inflammation must be obtained before surgery.

■ Surgical trauma should be minimized.

■ IOL implantation may be proposed in selected patients with well-controlled JIA-associated uveitis.

■ Postoperatively, the anti-inflammatory medication must be increased and continued for 8–12 weeks.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hooper PL, Rao NA, Smith RE (1990) Cataract extraction in uveitis patients. Surv Ophthalmol 35:120–144

    Article  PubMed  CAS  Google Scholar 

  2. Rosenberg KD, Feuer WJ, Davis JL (2005) Ocular complications of pediatric uveitis. Ophthalmology 111:2299–2306

    Article  Google Scholar 

  3. Mingels A, Hudde T, Heinz C, et al. (2005) Vision-threatening complications in childhood uveitis. Ophthalmologe 102:477–484

    Article  PubMed  CAS  Google Scholar 

  4. Okhravi N, Lightman SL, Towler HMA (1999) Assessment of visual outcome after cataract surgery in patients with uveitis. Ophthalmology 106:710–722

    Article  PubMed  CAS  Google Scholar 

  5. Kanski JJ (1977) Anterior uveitis in juvenile rheumatoid arthritis. Arch Ophthalmol 95:1794–1797

    PubMed  CAS  Google Scholar 

  6. Kotaniemi K, Kautiainen H, Karma A, et al. (2001) Occurrence of uveitis in recently diagnosed juvenile chronic arthritis. A prospective study. Ophthalmology 108:2071–2075

    Article  PubMed  CAS  Google Scholar 

  7. Foster CS, Barrett F (1993) Cataract development and cataract surgery in patients with juvenile rheumatoid arthritis-associated iridocyclitis. Ophthalmology 100:809–817

    PubMed  CAS  Google Scholar 

  8. Heger H, Drolsum L, Haaskjold E (1994) Cataract surgery with implantation of IOL in patients with uveitis. Acta Ophthalmol (Copenh) 72:478–482

    CAS  Google Scholar 

  9. Scott JD (1982) Lens epithelial proliferation in retinal detachment. Trans Ophthalmol Soc U K 102:385–389

    PubMed  Google Scholar 

  10. Kaufman AH, Foster CS (1993) Cataract extraction in patients with pars planitis. Ophthalmology 100:1210–1217

    PubMed  CAS  Google Scholar 

  11. Knight-Nanan D, O’Keefe M, Bowell R (1996) Outcome and complications of intraocular lenses in children with cataract. J Cataract Refract Surg 22:730–736

    PubMed  CAS  Google Scholar 

  12. Malukiewicz-Wisniewska G, Kaluzny J, Lesiewska-Junk H, et al. (1999) Intraocular lens implantation in children and youth. J Pediatr Ophthalmol Strabismus 36:129–133

    PubMed  CAS  Google Scholar 

  13. Menezo JL, Taboada JF, Ferrer E (1985) Complications of intraocular lenses in children. Trans Ophthalmol Soc U K 104:546–552

    PubMed  Google Scholar 

  14. Morgan KS (1995) Pediatric cataract and lens implantation. Curr Opin Ophthalmol 6:9–13

    PubMed  CAS  Google Scholar 

  15. Brady KM, Atkinson CS, Kilty LA, et al. (1995) Cataract surgery and intraocular lens implantation in children. Am J Ophthalmol 120:1–9

    PubMed  CAS  Google Scholar 

  16. Amon M (2001) Biocompatibility of intraocular lenses. J Cataract Refract Surg 27:178–179

    Article  PubMed  CAS  Google Scholar 

  17. Sanders DR, Kraff MC, Lieberman HL, et al. (1982) Breakdown and reestablishment of blood–aqueous barrier with implant surgery. Arch Ophthalmol 100:588–590

    PubMed  CAS  Google Scholar 

  18. Kazatchkine MD, Carreno MP (1988) Activation of the complement system at the interface between blood and artificial surfaces. Biomaterials 9:30–35

    Article  PubMed  CAS  Google Scholar 

  19. Mondino BJ, Rao H (1983) Hemolytic complement activity in aqueous humor. Arch Ophthalmol 101:465–468

    PubMed  CAS  Google Scholar 

  20. Sandberg HO, Closs O (1979) The alpha and gamma crystallin content in aqueous humor of eyes with clear lenses and with cataracts. Exp Eye Res 28:601–610

    Article  PubMed  CAS  Google Scholar 

  21. Voorter CE, De Haard-Hoekman WA, Hermans MM (1990) Differential synthesis of crystallins in the developing rat eye lens. Exp Eye Res 50:429–437

    Article  PubMed  CAS  Google Scholar 

  22. Murray PI, Clay CD, Mappin C, et al. (1999) Molecular analysis of resolving immune responses in uveitis. Clin Exp Immunol 117:455–461

    Article  PubMed  CAS  Google Scholar 

  23. Linnola RJ, Werner L, Pandey SK, et al. (2000) Adhesion of fibronectin, vitronectin, laminin, and collagen type IV to intraocular lens materials in pseudophakic human autopsy eyes. Part 1: histological sections. J Cataract Refract Surg 26:1792–1806

    Article  PubMed  CAS  Google Scholar 

  24. Wilson ME, Apple PPJ, Bluestein EC, et al. (1994) Intraocular lenses for pediatric implantation: biomaterials, designs, and sizing. J Cataract Refract Surg 20:584–591

    PubMed  CAS  Google Scholar 

  25. Dahan E, Drusedau MU (1997) Choice of lens and dioptric power in pediatric pseudophakia. J Cataract Refract Surg 23:618–623

    PubMed  Google Scholar 

  26. Jabs DA, Nussenblatt RB, Rosenbaum JT (2005) Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol 140:509–516

    Article  PubMed  Google Scholar 

  27. Alio JL, Chipont EC, BenEzra D, et al. (2002) Comparative performance of intraocular lenses in eyes with cataract and uveitis. J Cataract Refract Surg 28:2096–2108

    Article  PubMed  Google Scholar 

  28. Matsuo T, Takahashi M, Inoue Y, et al. (2001) Ocular attacks after phacoemulsification and intraocular lens implantation in patients with Behçet disease. Ophthalmologica 215:179–182

    Article  PubMed  CAS  Google Scholar 

  29. Estafanous MFG, Lowder CY, Meisler DM, et al. (2001) Phacoemulsification cataract extraction and posterior chamber lens implantation in patients with uveitis. Am J Ophthalmol 131:620–625

    Article  PubMed  CAS  Google Scholar 

  30. Foster RE, Lowder CY, Meisler DM, et al. (1992) Extracapsular cataract extraction and posterior chamber intraocular lens implantation in uveitis patients. Ophthalmology 99:1234–1241

    PubMed  CAS  Google Scholar 

  31. Abela-Formanek C, Amon M, Schauersberger J, et al. (2002) Uveal and capsular biocompatibility of 2 foldable acrylic lenses in patients with uveitis or pseudoexfoliation syndrome. Comparison to a control group. J Cataract Refract Surg 28:1160–1172

    Article  PubMed  Google Scholar 

  32. Kanski JJ (1992) Lensectomy for complicated cataract in juvenile chronic iridocyclitis. Br J Ophthalmol 76:72–75

    Article  PubMed  CAS  Google Scholar 

  33. Holland GN (1996) Intraocular lens implantation in patients with juvenile rheumatoid arthritis-associated uveitis: an unsolved management issue. Am J Ophthalmol 122:255–257

    PubMed  CAS  Google Scholar 

  34. Tabbara KF, Chavis PS (1995) Cataract extraction in patients with chronic posterior uveitis. Int Ophthalmol Clin 35:121–131

    Article  PubMed  CAS  Google Scholar 

  35. Mieler WF, Will BR, Lewis H, et al. (1988) Vitrectomy in the management of peripheral uveitis. Ophthalmology 95:859–864

    PubMed  CAS  Google Scholar 

  36. Dharmaraj S, Azar N (2005) Controversies of implanting intraocular lenses in infancy. Int Ophthalmol Clin 45:61–81

    Article  PubMed  Google Scholar 

  37. Foster CS, Fong LP, Singh G (1989) Cataract surgery and intraocular lens implantation in patients with uveitis. Ophthalmology 96:281–288

    PubMed  CAS  Google Scholar 

  38. Binkhorst CD, Gobin MH, Leonard PA (1969) Post-traumatic artificial lens implants (pseudophakoi) in children. Br J Ophthalmol 53:518–529

    Article  PubMed  CAS  Google Scholar 

  39. Tessler AH, Farber MD (1992) Intraocular lens implantation versus no intraocular lens implantation in patients with chronic iridocyclitis and pars planitis. Ophthalmology 100:1206–1209

    Google Scholar 

  40. Probst LE, Holland EJ (1996) Intraocular lens implantation in patients with juvenile rheumatoid arthritis. Am J Ophthalmol 122:161–170

    PubMed  CAS  Google Scholar 

  41. Lundvall A, Zetterstrom C (2000) Cataract extraction and intraocular lens implantation in children with uveitis. Br J Ophthalmol 84:791–793

    Article  PubMed  CAS  Google Scholar 

  42. Lam DS, Law RW, Wong AK (1998) Phacoemulsification, primary posterior capsulorhexis, and capsular intraocular lens implantation for uveitic cataract. J Cataract Refract Surg 24:1111–1118

    PubMed  CAS  Google Scholar 

  43. BenEzra D, Cohen E (2000) Cataract surgery in children with chronic uveitis. Ophthalmology 107:1255–1260

    Article  PubMed  CAS  Google Scholar 

  44. Terrada C, Bodaghi B, Burtin T, et al. (2005) Implantation of intraocular lens in children with uveitis: long-term visual outcome and prognosis. American Academy of Ophthalmology. Chicago

    Google Scholar 

  45. Vasavada AR, Trivedi RH, Singh R (2001) Necessity of vitrectomy when optic capture is performed in children older than 5 years. J Cataract Refract Surg 27:1185–1193

    Article  PubMed  CAS  Google Scholar 

  46. Borgioli M, Coster DJ, Fan FT, et al. (1992) Effect of heparin surface modification of polymethylmethacrylate intraocular lenses on signs of postoperative inflammation after extracapsular cataract extraction. Ophthalmology 99:1248–1255

    PubMed  CAS  Google Scholar 

  47. Lin CL, Wang AG, Chou JCK, et al. (1994) Heparin-surface-modified intraocular lens implantation in patients with glaucoma, diabetes, or uveitis. J Cataract Refract Surg 20:550–553

    PubMed  CAS  Google Scholar 

  48. Schauersberger J, Kruger A, Abela C, et al. (1999) Course of postoperative inflammation after implantation of 4 types of foldable intraocular lenses. J Cataract Refract Surg 25:1116–1120

    Article  PubMed  CAS  Google Scholar 

  49. Wilson ME, Bluestein EC, Wang XH (1994) Current trends in the use of intraocular lenses in children. J Cataract Refract Surg 20:579–583

    PubMed  CAS  Google Scholar 

  50. Wilson ME, Elliott L, Johnson B, et al. (2001) AcrySof acrylic intraocular lens implantation in children: clinical indications of biocompatibility. J AAPOS 5:377–380

    Article  PubMed  CAS  Google Scholar 

  51. Hollick EJ, Spalton DJ, Ursell PG, et al. (1998) Biocompatibility of poly (methyl methacrylate), silicone, and AcrySof intraocular lenses: randomized comparison of the cellular reaction on the anterior lens surface. J Cataract Refract Surg 24:361–366

    PubMed  CAS  Google Scholar 

  52. Nishi O, Nishi K, Sakanishi K (1998) Inhibition of migrating lens epithelial cells at the capsular bend created by the rectangular optic edge of a posterior chamber intraocular lens. Ophthalmic Surg Lasers 29:587–594

    PubMed  CAS  Google Scholar 

  53. Sharma A, Basti S, Gupta S (1997) Secondary capsule-supported intraocular lens implantation in children. J Cataract Refract Surg 23:675–680

    PubMed  Google Scholar 

  54. Wilson-Holt N, Hing S, Taylor DS (1991) Bilateral blinding uveitis in a child after secondary intraocular lens implantation for unilateral congenital cataract. J Pediatr Ophthalmol Strabismus 28:116–118

    PubMed  CAS  Google Scholar 

  55. Foster CS, Havrou P, Zafirakis P, et al. (1999) Intraocular lens-explantation in patients with uveitis. Am J Ophthalmol 128:31–37

    Article  PubMed  CAS  Google Scholar 

  56. Meacock WR, Spalton DJ, Bender L, et al. (2004) Steroid prophylaxis in eyes with uveitis undergoing phacoemulsification. Br J Ophthalmol 88:1122–1124

    Article  PubMed  CAS  Google Scholar 

  57. Antcliff RJ, Spalton DJ, Stanford MR, et al. (2001) Intravitreal triamcinolone for uveitic cystoid macular edema: an optical coherence tomography study. Ophthalmology 108:765–772

    Article  PubMed  CAS  Google Scholar 

  58. Paganelli F, Cardillo JA, Melo LAS, et al. (2004) A single intraoperative sub-tenon´s capsule triamcinolone acetonide injection for the treatment of post-cataract surgery inflammation. Ophthalmology 111:2102–2108

    Article  PubMed  Google Scholar 

  59. Jonas JB (2002) Concentration of intravitreally injected triamcinolone acetonide in aqueous humour. Br J Ophthalmol 86:1450–1451

    Article  PubMed  CAS  Google Scholar 

  60. Jonas JB, Hayler JK, Panda-Jonas S (2000) Intravitreal injection of crystalline cortisone as adjunctive treatment of proliferative vitreoretinopathy. Br J Ophthalmol 84:1064–1067

    Article  PubMed  CAS  Google Scholar 

  61. Young S, Larkin G, Branley M, et al. (2001) Safety and efficacy of intravitreal triamcinolone for cystoid macular oedema in uveitis. Clin Experiment Ophthalmol 29:23–26

    Article  Google Scholar 

  62. Sonoda KH, Enaida H, Ueno A, et al. (2003) Pars plana vitrectomy assisted by triamcinolone acetonide for refractory uveitis: a case series study. Br J Ophthalmol 87:1010–1014

    Article  PubMed  Google Scholar 

  63. Wadood AC, Armbrecht AM, Aspinall PA, et al. (2004) Safety and efficacy of a dexamethasone anterior segment drug delivery system in patients after phacoemulsification. J Cataract Refract Surg 30:761–768

    Article  PubMed  Google Scholar 

  64. Beer PM, Bakri SJ, Singh RJ, et al. (2003) Intraocular concentrations and pharmacokinetics of triamcinolone acetonice after a single intravitreal injection. Ophthalmology 110:681–686

    Article  PubMed  Google Scholar 

  65. Yamakiri K, Uchino E, Kimura K, et al. (2004) Intracameral triamcinolone helps to visualize and remove the vitreous body in anterior chamber in cataract surgery. Am J Ophthalmol 138:650–652

    Article  PubMed  CAS  Google Scholar 

  66. Rauz S, Stavrou P, Murray PI (2000) Evaluation of foldable intraocular lenses in patients with uveitis. Ophthalmology 107:909–919

    Article  PubMed  CAS  Google Scholar 

  67. El-Osta AA, Spalton DJ, Marshall J (2003) In vitro model for the study of human posterior capsule opacification. J Cataract Refract Surg 29:1593–1600

    Article  PubMed  Google Scholar 

  68. Koch DD, Kohnen T (1997) Retrospective comparison of techniques to prevent secondary cataract formation after posterior chamber intraocular lens implantation in infants and children. J Cataract Refract Surg 23:657–663

    PubMed  Google Scholar 

  69. Kugelberg M, Zetterstrom C (2002) Pediatric cataract surgery with or without anterior vitrectomy. J Cataract Refract Surg 28:1770–1773

    Article  PubMed  Google Scholar 

  70. Buehl W, Findle O, Menapace R (2002) Effect of an acrylic intraocular lens with a sharp posterior optic edge on posterior capsule opacification. J Cataract Refract Surg 28:1105–1111

    Article  PubMed  Google Scholar 

  71. Meacock WR, Spalton DJ, Hollick EJ (2000) Double masked prospective ocular safety study of a lens epithelial cell antibody to prevent posterior capsule opacification. J Cataract Refract Surg 26:716–721

    Article  PubMed  CAS  Google Scholar 

  72. Menapace R, Wirtitsch M, Findl O, et al. (2005) Effect of anterior capsule polishing on posterior capsule opacification and neodym:YAG capsulotomy rates: three-year randomized trial. J Cataract Refract Surg 31:2067–2075

    Article  PubMed  Google Scholar 

  73. Menapace R, Findl O, Georgopoulos M (2000) The capsular tension ring: designs, applications, and techniques. J Cataract Refract Surg 26:898–912

    Article  PubMed  CAS  Google Scholar 

  74. Nishi O, Nishi K, Menapace R, et al. (2001) Capsular bending ring to prevent posterior capsule opacification: 2 year follow-up. J Cataract Refract Surg 27:1359–1365

    Article  PubMed  CAS  Google Scholar 

  75. Asrani S, Freedman S, Hasselblad V, et al. (2000) Does primary intraocular lens implantation prevent “aphacic” glaucoma in children? J AAPOS 4:33–39

    Article  PubMed  CAS  Google Scholar 

  76. Morse LS, McCuen BW (1991) The use of silicone oil in uveitis and hypotony. Retina 11:399–404

    PubMed  CAS  Google Scholar 

  77. Heiligenhaus A, Steinmetz B, Lapuente R, et al. (1998) Recombinant tissue plasminogen activator in cases with fibrin formation after cataract surgery: a prospective randomized multicentre study. Br J Ophthalmol 82:810–815

    Article  PubMed  CAS  Google Scholar 

  78. Cox SN, Hay E, Bird AC (1988) Treatment of macular edema with acetazolamide. Arch Ophthalmol 106:1190–1195

    PubMed  CAS  Google Scholar 

  79. Schilling H, Heiligenhaus A, Laube T, et al. (2005) Long-term effect of acetazolamide of patients with uveitic chronic cystoid macular edema is limited by persisting inflammation. Retina 25:182–188

    Article  PubMed  Google Scholar 

  80. Paikos P, Fotopoulou M, Papathanassiou M, et al. (2001) Cataract surgery in children with uveitis. J Pediatr Ophthalmol Strabismus 38:16–20

    PubMed  CAS  Google Scholar 

  81. Moorthy RS, Rajeev B, Smith RE, et al. (1994) Incidence and management of cataracts in Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol 118:197–204

    PubMed  CAS  Google Scholar 

  82. Wilson ME Jr, Trivedi RH, Bartholomew LR, Pershing S (2007) Comparison of anterior vitrectorhexis and continuous curvilinear capsulorhexis in pediatric cataract and intraocular lens implantation surgery: a 10-year analysis. J AAPOS 11:443–446

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany

    Arnd Heiligenhaus & Carsten Heinz

  2. Pitié-Salpêtrière Hospital, Department of Ophthalmology, Pierre and Marie Curie University, 47–83 boulevard de l’Hopital, 75651, Paris, France

    Bahram Bodaghi

Authors
  1. Arnd Heiligenhaus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carsten Heinz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bahram Bodaghi
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Universitäts-Augenklinik Heidelberg, Interdisziplinäres Uveitiszentrum, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    Matthias Becker

  2. Dept. of Ophthalmology, Triemli Hospital Zürich, Birmensdorfer Straße 497, 8063, Zürich, Switzerland

    Matthias Becker

  3. Ophthalmology, Univ. of Miami Bascom Palmer, 900 NW 17th Street, 33136, Miami, FL, FL, USA

    Janet Davis

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Heiligenhaus, A., Heinz, C., Bodaghi, B. (2008). Cataract Surgery in Childhood Uveitis. In: Becker, M., Davis, J. (eds) Surgical Management of Inflammatory Eye Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33862-8_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-33862-8_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33861-1

  • Online ISBN: 978-3-540-33862-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation