UVEITIC CATARACTS IN CHILDREN: ABOUT 18 EYES

Our work aims to study the therapeutic particularities, the per and postoperative complications and the visual and functional results of these cataracts.

We are studying , epidemiological, clinical profil and per and post operative results 

We performed a retrospective study of 14 patients (18 eyes) involving children under 15 years of age who underwent cataract surgery between January 2011 and November 2022. The operative protocol consisted of phaco exeresis with posterior capsulorhexis, anterior vitrectomy, and implantation into the capsular bag. Surgery was indicated after a minimum lull period of 6 months. All patients received a corticosteroid bolus preoperatively and some underwent amblyopia treatment postoperatively. The main follow-up criteria were visual acuity, slit lamp examination and immunosuppressive therapy.

 
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 etiology 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 etiology 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 cortico-nuclear and posterior subcapsular in 11% of cases.  Phacoaspiration 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 edema 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.

Cataract surgery in uveitic children requires careful management to ensure successful outcomes. The control of perioperative inflammation in the surgery of pediatric uveitic cataracts is the key to obtaining good visual outcomes and preventing amblyopia.