The outcome of cataract surgery in paediatric uveitis

Abstract

Aims/Purpose: Cataract is a frequent complication of chronic uveitis. It can be a consequence of intraocular inflammation or the use of corticosteroids. In children, uveitic cataract is a source of amblyopia, hence the interest in surgery. Our work aims to study the therapeutic particularities, the peri and post‐operative complications and the visual and functional results of these cataracts.Methods: We performed a retrospective study of 14 patients (18 eyes) with uveitis; involving children under 15 years of age; who underwent cataract surgery between January 2011 and November 2022.Results: The average age of the operated children was 9.5 years (4–14 years) with a female predominance of 70%. Uveitis was bilateral in 8 children. The aetiology of the uveitis was found in 9 patients. It was juvenile idiopathic arthritis (JIA) in 6 cases, ocular toxoplasmosis in 1 case, tuberculosis in 1 case and Eales disease in 1 case. The aetiology of the uveitis was not found in 5 patients. The initial visual acuity varied between light perception and 2/10. Total white cataract was found in 44% of cases, posterior subcapsular in 39% of cases, anterior subcapsular in 5.5% of cases and corticonuclear and posterior subcapsular in 11% of cases. Phacoemulsification was performed with implantation in the lens bag in 17 eyes, only 1 patient in our series was not implanted. Post‐operative visual acuity was greater than 7/10 in 68% of cases, between 7/10 and 3/10 in 16% of cases and less than 3/10 in 16% of patients. Post‐operative complications were dominated by the inflammatory reaction of the anterior segment, which was controlled by corticosteroid treatment in 40% of cases, macular oedema occurred in 2 patients in our series post‐operatively and Elsching's beads in 6 eyes (34%). Immunosuppressive treatment was maintained in 75% of cases.Conclusions: Cataract surgery in uveitic children requires careful management to ensure successful outcomes. The control of peri‐operative inflammation in the surgery of paediatric uveitic cataracts is the key to obtaining good visual outcomes and preventing amblyopia.ReferencesAlAmeer AM, Al Shamrani M. Outcome of cataract surgery in pediatric uveitis (experience at King Khalid Eye Hospital). Oman J Ophthalmol. 2022 Mar 2;15(1):43–48.