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S. M. Acevedo, V. Rao, K. Quiñones, R. A. Cervantes-Castañeda, C. S. Foster; Pediatric Cataract Surgery Outcomes in Juvenile Idiopathic Arthritis Associated Uveitis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5471.
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To analyze visual outcomes following cataract extraction in patients with juvenile idiopathic arthritis (JIA) associated uveitis.
The clinical records of patients younger than 18 years old with JIA associated uveitis followed from January 1985 to December 2005 were reviewed. We identified 24 patients (30 eyes) who underwent cataract extraction with follow-up of ≥ 1 year. The main outcome measure was postoperative visual acuity (Va) after 1 year.
The mean age of patients at surgery was 8.9 years (range: 4.5-16 years). Overall, 93.3% (28/30) of eyes showed improvement or maintenance of Va, while Va in 6.7% (2/30) of eyes worsened. Forty seven percent (14) had final Va of >20/50, 30% (9) between 20/50 and >20/200, and 23.3% (7) with ≤20/200, the majority of which was attributable to pre-existing retinal or optic nerve pathology. Additionally, 76.7% (23) underwent concomitant pars plana vitrectomy, of which 21 (91.3%) showed improved vision. Twenty-three eyes (76.7%) were left aphakic, while 7 (23.3%) had lens implantation. The 7 eyes which received IOL implant had improved vision 1 year following the procedure.
While cataract extraction results in visual improvement in most pediatric patients, this may not hold true for all patients with JIA-associated uveitis. Chronic inflammation, along with an increased risk of post-operative complications, makes the decision of performing surgery in this cohort more challenging. We found that patients with JIA associated uveitis may benefit from cataract extraction given careful patient selection, optimal control of inflammation, and meticulous surgical planning.
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