Causes of Reduced Visual Acuity on Long-term Follow-up After Cataract Extraction in Patients With Uveitis and Juvenile Rheumatoid Arthritis

Fox, Gregory M.; Flynn, Harry W.; Davis, Janet L.; Culbertson, William W.

doi:10.1016/s0002-9394(14)74049-8

Cited by 48 publications

(12 citation statements)

References 12 publications

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“…Fox et al [23] described 16 patients with various types of uveitis associated with ankylosing spondylitis in 5 and inflammatory bowel disease in two. All patients had less than 0–2 anterior chamber cells for at least three months preceding surgery.…”

Section: Review Of Current Literaturementioning

confidence: 99%

Cataract Surgery in Uveitis

Agrawal

Murthy

Ganesh³

et al. 2012

International Journal of Inflammation

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Cataract surgery in uveitic eyes is often challenging and can result in intraoperative and postoperative complications. Most uveitic patients enjoy good vision despite potentially sight-threatening complications, including cataract development. In those patients who develop cataracts, successful surgery stems from educated patient selection, careful surgical technique, and aggressive preoperative and postoperative control of inflammation. With improved understanding of the disease processes, pre- and perioperative control of inflammation, modern surgical techniques, availability of biocompatible intraocular lens material and design, surgical experience in performing complicated cataract surgeries, and efficient management of postoperative complications have led to much better outcome. Preoperative factors include proper patient selection and counseling and preoperative control of inflammation. Meticulous and careful cataract surgery in uveitic cataract is essential in optimizing the postoperative outcome. Management of postoperative complications, especially inflammation and glaucoma, earlier rather than later, has also contributed to improved outcomes. This manuscript is review of the existing literature and highlights the management pearls in tackling complicated cataract based on medline search of literature and experience of the authors.

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Section: Review Of Current Literaturementioning

confidence: 99%

Cataract Surgery in Uveitis

Agrawal

Murthy

Ganesh³

et al. 2012

International Journal of Inflammation

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“…Many authorities continue to recommend pars plana lensectomy and vitrectomy for children who develop cataract in the setting of severe chronic forms of uveitis, such as JIA. [49][50][51][52] …”

Section: Uveitis In Childrenmentioning

confidence: 99%

Uveitis in children

2000

Ocular Immunology and Inflammation

193

115

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“…Finally, the results of surgical procedures for the various complications of uveitis (for example, cataract, glaucoma) in children are often discouraging. [18][19][20][21] The exact visual prognosis of children with JIA is not known; in the past 5 years, rates of blindness ranging from 6-25% have been published for JIA associated uveitis. 16 22 A recent review of the literature indicated that up to one third of all children with uveitis ended with severe visual impairment.…”

mentioning

confidence: 99%

Visual loss in uveitis of childhood

Boer

Wulffraat²,

Rothová³

2003

British Journal of Ophthalmology

256

147

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Aims: To investigate the manifestations and severity of uveitis in children and to identify the risk and specific causes of blindness in this population. Methods: Retrospective study of data of 123 consecutive patients examined with active uveitis and the onset of ocular disease before the age of 16 years. Numerous variables were assessed including age and sex distribution, laboratory data, the presence of systemic diseases, onset and course of ocular inflammation, clinical features and complications, therapeutic strategies and their outcomes, final visual acuity, and characteristics associated with poor visual outcome. Results: Systemic disease was observed in 36/123 patients (29%), with juvenile idiopathic arthritis being the most frequent (25/123, 20%). Toxoplasma retinochoroiditis was diagnosed in 12/23 patients with posterior uveitis (52%; 10% of all with uveitis). Severe intraocular inflammation required systemic drugs in 57 (46%) patients. Ocular complications were observed in 93 patients (76%), of which the most common was cataract (43/123, 35%). Intraocular surgery was required in 35 patients (28%; in total 75 procedures). Three patients (2%) became legally blind and an additional 20/121 (17%) had one legally blind eye caused by uveitis. The most frequent causes of blindness were chorioretinal scars in the macular area and glaucoma in contrast with cystoid macular oedema (CMO) in adults. Conclusions: Uveitis in childhood is a potentially blinding disease, in the majority of patients characterised by a chronic course and a high complication rate.

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Causes of Reduced Visual Acuity on Long-term Follow-up After Cataract Extraction in Patients With Uveitis and Juvenile Rheumatoid Arthritis

Cited by 48 publications

References 12 publications

Cataract Surgery in Uveitis

Cataract Surgery in Uveitis

Uveitis in children

Visual loss in uveitis of childhood

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