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Cataract Surgery and IOL Implantation in Children with Uveitis

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Pediatric Cataract Surgery and IOL Implantation

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Abstract

Uveitis in children is often complicated by cataract formation due to chronic inflammation and steroid therapy. Pediatric intraocular lens (IOL) implantation in the setting of uveitis is controversial. Literature on this topic is limited, and there are no formal guidelines regarding perioperative management. Excellent visual outcomes are possible with adequate perioperative planning, including proper timing of IOL implantation as well as optimization of inflammation control. Support of a multidisciplinary team of pediatric ophthalmologists and rheumatologists is essential. Included are two cases that highlight some of the management challenges inherent to uveitic cataracts in children. The first case involves a patient with idiopathic chronic anterior uveitis complicated by cataract formation and uveitic glaucoma. The second case presents a patient with JIA-associated anterior and intermediate uveitis who developed cataracts and ocular hypertension. Discussion by both a pediatric ophthalmologist and uveitis specialist regarding surgical technique, amblyopia management, uveitis control, and appropriateness for IOL implantation follows each case.

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References

  1. Kesen MR, Setlur V, Goldstein DA. Juvenile idiopathic arthritis-related uveitis. Int Ophthalmol Clin. 2008;48:21–38.

    Article  Google Scholar 

  2. De Boer J, Wulffraat N, Rothova A. Visual loss in uveitis of childhood. Br J Ophthalmol. 2003;87:879–84.

    Article  Google Scholar 

  3. Kotaniemi K, Savolainen A, Karma A, Aho K. Recent advances in uveitis of juvenile idiopathic arthritis. Surv Ophthalmol. 2003;48:489–502.

    Article  Google Scholar 

  4. Terrada C, Julian K, Cassoux N, et al. Cataract surgery with primary intraocular lens implantation in children with uveitis: long-term outcomes. J Cataract Refract Surg. 2011;37:1977–83.

    Article  Google Scholar 

  5. Clarke LA, Guex-Crosier Y, Hofer M. Epidemiology of uveitis in children over a 10-year period. Clin Exp Rheumatol. 2013;31:633–7.

    PubMed  Google Scholar 

  6. Van Gelder RN, Leveque TK. Cataract surgery in the setting of uveitis. Curr Opin Ophthalmol. 2009;20:42–5.

    Article  Google Scholar 

  7. Probst LE, Holland EJ. Intraocular lens implantation in patients with juvenile rheumatoid arthritis. Am J Ophthalmol. 1996;122:161–70.

    Article  CAS  Google Scholar 

  8. Mester U, Strauss M, Grewing R. Biocompatibility and blood-aqueous barrier impairment in at-risk eyes with heparin-surface-modified or unmodified lenses. J Cataract Refract Surg. 1998;24:380–4.

    Article  CAS  Google Scholar 

  9. Miyake K, Ota I, Miyake S, et al. Correlation between intraocular lens hydrophilicity and anterior capsule opacification and aqueous flare. J Cataract Refract Surg. 1996;22(suppl 1):764–9.

    Article  Google Scholar 

  10. Plager DA, Lynn MJ, Buckley EG, Wilson ME, Lambert SR. Infant Aphakia treatment study G complications in the first 5 years following cataract surgery in infants with and without intraocular lens implantation in the infant Aphakia treatment study. Am J Ophthalmol. 2014;158:892–8.

    Article  Google Scholar 

  11. Vasavada AR, Nihalani BR. Pediatric cataract surgery. Curr Opin Ophthalmol 2006;17:54–61. Gupta R, Ram J, Sukhija J, Singh R. Outcome of paediatric cataract surgery with primary posterior capsulotomy and anterior vitrectomy using intra-operative preservative-free triamcinolone acetonide. Acta Ophthalmol. 2014;92:e358–61.

    Google Scholar 

  12. Lambert SR, Buckley EG, Drews-Botsch C, et al. Infant Aphakia Treatment Study Group. The infant aphakia treatment study: design and clinical measures at enrollment. Arch Ophthalmol. 2010;128:21–7.

    Article  Google Scholar 

  13. Holland GN, Stiehm ER. Special considerations in the evaluation and management of uveitis in children. Am J Ophthalmol. 2003;135:867–78.

    Article  Google Scholar 

  14. Foster CS, Fong LP, Singh G. Cataract surgery and intraocular lens implantation in patients with uveitis. Ophthalmology. 1989;96:281–8.

    Article  CAS  Google Scholar 

  15. De Boer J, Berendschot TTJM, Van Der Does P, Rothova A. Long-term follow-up of intermediate uveitis in children. Am J Ophthalmol. 2006;141:616–21.

    Article  Google Scholar 

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Authors and Affiliations

  1. University of Minnesota, Minneapolis, MN, USA

    Sydni Coleman, Karen R. Armbrust & Raymond G. Areaux Jr.

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  1. Sydni Coleman
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  2. Karen R. Armbrust
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  3. Raymond G. Areaux Jr.
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Correspondence to Raymond G. Areaux Jr. .

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Editors and Affiliations

  1. Department of Ophthalmology, Johns Hopkins Hospital Wilmer Eye Institute, Baltimore, MD, USA

    Courtney L. Kraus

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Coleman, S., Armbrust, K.R., Areaux, R.G. (2020). Cataract Surgery and IOL Implantation in Children with Uveitis. In: Kraus, C. (eds) Pediatric Cataract Surgery and IOL Implantation. Springer, Cham. https://doi.org/10.1007/978-3-030-38938-3_21

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  • DOI: https://doi.org/10.1007/978-3-030-38938-3_21

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-38937-6

  • Online ISBN: 978-3-030-38938-3

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