Pars plana vitrectomy as anti-inflammatory therapy for intermediate uveitis in children

Abstract

PurposeIntermediate uveitis represents between 2 and 26% of uveitis in children. The spectrum of the disease is highly variable, ranging between mild cases that resolve spontaneously and chronic, severe forms that develop multiple episodes and complications. The purpose of this study is to evaluate the efficacy of vitrectomy to control inflammation in children with recurrent intermediate uveitis. MethodsRetrospective evaluation of patients with at least six months of follow-up. All patients under 16 who had undergone vitrectomy for intermediate uveitis were included. Vitrectomy was performed after at least two episodes of intermediate uveitis in children that had had no previous prophylactic systemic immunosuppressant treatment. Data recorded were visual acuity (VA), recurrences and surgical complications. ResultsSeven eyes of five children with intermediate uveitis who underwent vitrectomy were included. After a mean follow-up of 34 months, VA improved in all eyes after surgery. Four eyes developed mild subcapsular posterior cataracts. Post-surgical recurrences were anterior and responded to topical treatment, except for an episode of intermediate uveitis that required a periocular injection of triamcinolone. Only one patient is being treated with systemic immunosuppressants, due to the presence of repeated episodes of uveitis in the non-vitrectomised eye and since his parents were unwilling to have him undergo new surgery. ConclusionsVitrectomy with inferior cryotheraphy controls inflammation in intermediate uveitis in children with good mid-term results avoiding the secondary side-effects of systemic immunosuppressants.