Abstract
This study compared the outcomes of cataract surgery with intraocular lens (IOL) implantation in patients with juvenile idiopathic arthritis (JIA)-associated chronic anterior uveitis treated with antimetabolite drugs and systemic corticosteroids (Non-Biological Group) versus patients treated with antimetabolites and biological drugs (Biological Group). A cohort of patients with cataract in JIA-associated uveitis undergoing phacoemulsification with IOL implantation was retrospectively evaluated. The main outcome was a change in corrected distance visual acuity (CDVA) in the two groups. Ocular and systemic complications were also recorded. The data were collected preoperatively and at 1, 12, and 48 months after surgery. Thirty-two eyes of 24 children were included: 10 eyes in the Non-Biological Group and 22 eyes in the Biological Group. The mean CDVA improved from 1.19 ± 0.72 logMAR preoperatively to 0.98 ± 0.97 logMAR at 48 months (p = 0.45) in the Non-Biological Group and from 1.55 ± 0.91 logMAR preoperatively to 0.57 ± 0.83 logMAR at 48 months (p = 0.001) in the Biological Group. The postoperative complications, including synechiae, cyclitic membrane, IOL explantation, glaucoma, and macular edema, were not statistically different between the two groups. An immunosuppressive treatment with biological drugs can improve the visual outcome after cataract surgery in patients with JIA-associated uveitis, but it does not significantly reduce postoperative ocular complications.
Highlights
Cataract is a frequent complication in juvenile idiopathic arthritis (JIA)-associated uveitis that occurs in 20–64% of children with JIA
Continuous variables were reported as the means and standard deviations (SDs) or median and interquartile range (IQR) and categorical variables as frequencies and percentages
The Non-Biological Group consisted of 10 eyes with a mean age at uveitis onset in the first eye of
Summary
Cataract is a frequent complication in juvenile idiopathic arthritis (JIA)-associated uveitis that occurs in 20–64% of children with JIA. It is caused by posterior synechiae, chronic inflammation, and corticosteroid treatment [1,2]. If surgery is not promptly performed, the formation of cataracts during visual development can lead to further complications, such as amblyopia and strabismus [3] Cataract surgery in these patients is challenging, and intraocular lens (IOL) implantation is controversial because of postoperative complications such as anterior and posterior synechiae, pupillary membrane, and secondary posterior capsule opacification (PCO) [4]. Other postoperative complications include secondary glaucoma, macular edema (ME), and retinal detachment [6]
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