Multimodal Management Of Advanced Uveitis Complications: Functional And Anatomical Results

To illustrate the effectiveness of a stepwise surgical approach in patient with complicated band keratopathy and cataract in case of autoimmune uveitis.

E-poster or case report presentation with photographic images, A0 size; displayed during the conference poster session.

A 7-year-old girl participated in the study. The diagnosis of autoimmune uveitis was established at the age of 5 years. The child has been receiving systemic immunosuppressive therapy. As a consequence of intraocular inflammation, band keratopathy and cataract developed in both eyes.

A staged approach was employed for the treatment. First phase – phototherapeutic keratectomy (PTK) in the right eye (OD) and subsequently in the left eye (OS). Second phase – phacoemulsification with intraocular lens implantation (Phaco+IOL) in the same sequence.

Preoperative best corrected distance visual acuity (BCVA) was hand motion in the OD and 20/1000 in the OS.

After PTK, BCVA in the OD – 20/100 and in the OS – 20/200. Additionally, the outcome included restoration of corneal transparency. The postoperative rehabilitation period was uneventful.

After Phaco+IOL the BCVA improved to 20/40 in the OD and 20/33 in the OS. The pediatric patient return to full participation in school.

Surgical procedures performed in conjunction with systemic steroidal therapy according to the established protocol.

No exacerbations of autoimmune uveitis were observed during the two-year follow-up period.

A comprehensive stepwise approach to the management of patients with band keratopathy and complicated cataract can provide favorable functional outcomes, provided that safety criteria specific to patients with chronic autoimmune uveitis are strictly observed. This is particularly important in pediatric patients to prevent the development of amblyopia.