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G. P. Giuliari, P. Thakuria, P. Y. Chang, D. M. Hinkle, C. S. Foster; Pars Plana Vitrectomy for Pediatric Uveitis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2687.
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To assess the usefulness of pars plana vitrectomy in the induction of inflammatory control in otherwise treatment resistant pediatric uveitis.
A chart review of patients less than 16 years old who underwent pars plana vitrectomy due to persistent intermediate and/or posterior uveitis, despite medical treatment, at the Massachusetts Eye Research and Surgery Institution. Data were collected regarding patient characteristics, surgical techniques, and inflammatory outcomes. Visual acuity, tonometry, biomicroscopic features, and surgical complications were analyzed.
35 eyes from 28 patients, ranging in age from 2 to 16 years were included. The most common diseases treated were pars planitis, in 19 of the 35 eyes (54%), idiopathic panuveitis in 9 eyes (26%), juvenile idiopathic arthritis (JIA) associated uveitis in 6 eyes (17%), and multifocal choroiditis and panuveitis (MCP) in one patient (3%). The mean follow up after the surgery was 13.8 months (range: 6-29 months). Control of the inflammatory disease with or without additional treatment was achieved in 34 of the 35 eyes (97%). There was no statistically significant improvement in the BCVA from baseline (last visit pre-operative) and the last day of follow up (p=0.006 Student’s t). The instrumentation was 20-gauge in 26 (74%) eyes and 25-gauge in 9 (26%) eyes. A complete PPV was done in 16 (46%) of the eyes, while a core vitrectomy was performed in the remaining 19 (54%). At the end of the follow up, 7 of the 14 eyes with clear lenses developed cataracts.
Pars plana vitrectomy is a safe and effective option to treat chronic uveitis and the complications associated with it in pediatric patients.
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