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L. S. Vera, E. Bui Quoc; Juvenile Idiopathic Arthritis-Associated Uveitis and Cataract in Children: A Study of Five Cases. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5292.
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To evaluate outcomes of cataract surgery with or without posterior chamber intraocular lens implantation (IOL) in children with juvenile rheumatoid arthritis (JRA)-associated uveitis.
Retrospective chart review of five patients aged 8 years or younger with JRA-associated uveitis who underwent cataract surgery with or without posterior chamber IOL at the Robert Debre Hospital from July 2007 to April 2009
Four female patients and one male patient ranging from age 4 to 8 years were identified. Four patient had bilateral involvement. Three eyes of three patients underwent cataract extraction with posterior chamber IOL, and three eyes (two patients)underwent cataract surgery without posterior chamber IOL. Median age at surgery was 6.0 years, with a median follow-up of 11.2 months. Three children were on systemic methotrexate immunosuppressive therapy for at least 3 months before surgery. All five patients received systemic and topical corticosteroid treatment 2 to 3 weeks preoperatively and postoperatively. Visual acuity improved in three patients. A final postoperative Snellen visual acuity below 20/40 was seen in two patients, due to corneal (band keratopathy) or retinal complications. Two patients developed ocular hypertension postoperatively.
With adequate long-term preoperative and postoperative control of intraocular inflammation with systemic immunosuppressive therapy in addition to intensive topical corticosteroid treatment, children with JRA-associated uveitis can demonstrate favorable surgical outcomes after cataract surgery with posterior chamber IOL.
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