Long Term Results Of Cataract Surgery In Patients With Juvenile Idiopathic Arthritis -Associated Uveitis

To evaluate long-term results of cataract surgery in patients with juvenile idiopathic arthritis (JIA) associated uveitis.

This retrospective study was conducted in Ege University, Ophthalmology Department, Izmir, Turkey.

In this retrospective cross-sectional study, 17 eyes of 12(5 female/7 male) JIA uveitis patients who underwent phacoemulsification(PE) ± intraocular lens (IOL) implantation surgery were enrolled. Demographic features, systemic and topical treatments, time of surgery, pre- and post-operative medications, additional surgeries, early and late complications were analysed. Best corrected visual acuity (BCVA) was given in logMAR.

Mean surgery age was 7.8±4.4(4-17)years, mean follow-up time was 76.8±43.2(12-144) mo. All patients were under topical and systemic(methotrexate) immunosuppressive treatment. Also 7 received anti-TNF(adalimumab). Primary IOL implantation was performed at same session in 14 eyes. Secondary implantation was performed in 2 eyes with a mean interval of 3.1±1.4 years. 1 eye did not receive IOL implantation due to uncontrolled inflammation. Pre and postoperative visual acuities were 0.74±0.88(0.1-3) and 0.42±0.34(0-3) logMAR(p=0.04). Postoperative complications were as follows:IOL explantation due to persistent uveitis(1), glaucoma required surgery(3), retinal detachment(1),posterior capsule opacification(7),pupillary membrane formation(1)

Cataract is one of the main causes of visual impairment in children with JIA. Intense control of the inflammation pre- and post-operatively is essential and will secure the IOL implantation success. IOL explantation might still be needed in case of uncontrollable inflammation.