Department of Ophthalmology, University of Paris VI, Pitié-Salpêtrière Hospital, APHP, Necker Hospital, Paris, France.
J Cataract Refract Surg. 2011 Nov;37(11):1977-83. doi: 10.1016/j.jcrs.2011.05.037. Epub 2011 Sep 22.
To report long-term outcomes of cataract surgery with primary posterior chamber intraocular lens (IOL) implantation in children with chronic uveitis.
Department of Ophthalmology, Pitié-Salpêtrière Hospital, Paris, France.
Case series.
This case series comprised patients younger than 16 years with chronic uveitis who underwent phacoemulsification with primary implantation of a heparin surface-modified poly(methyl methacrylate) posterior chamber IOL in the capsular bag. The intraocular inflammation was fully controlled for at least 3 consecutive months before surgery in all cases. The main outcome measures were final corrected distance visual acuity (CDVA), postoperative inflammation, complications, and level of immunosuppressive treatment.
Twenty-two eyes of 16 children (7 girls, 9 boys; median age at surgery 9.5 years old) were included. Underlying uveitic entities were juvenile idiopathic arthritis in 9 patients; idiopathic uveitis in 4; and Behçet disease, sarcoidosis, and varicella zoster-associated uveitis in 1 patient each. The final CDVA was 0.3 logMAR or better in all cases. Postoperative complications included posterior capsule opacification requiring laser capsulotomy in 2 eyes, glaucoma in 4 eyes, and cystoid macular edema/macular dysfunction in 3 eyes. The mean dose of oral prednisone was 29.5 mg/day preoperatively and 8.13 mg/day at the last follow-up. The median follow-up was 6 years (range 5 to 19 years).
The results indicate that uveitis is not a formal contraindication to primary IOL implantation in the management of pediatric cataract surgery in cases with full control of intraocular inflammation.
No author has a financial or proprietary interest in any material or method mentioned.
报告儿童慢性葡萄膜炎患者行后房型人工晶状体（IOL）一期植入白内障手术后的长期疗效。
法国巴黎皮提-萨尔佩特里埃医院眼科。
病例系列。
该病例系列纳入了 16 岁以下患有慢性葡萄膜炎且行白内障超声乳化吸除联合肝素表面修饰的聚甲基丙烯酸甲酯后房型 IOL 囊袋内植入术的患者。所有患者术前均有至少连续 3 个月的眼内炎症得到完全控制。主要观察指标为最终矫正远视力（CDVA）、术后炎症、并发症和免疫抑制治疗水平。
共纳入 16 例（7 名女孩，9 名男孩）22 只眼的患者。9 例患者的葡萄膜炎病因是幼年特发性关节炎，4 例为特发性葡萄膜炎，1 例为贝切特病、结节病和水痘带状疱疹相关性葡萄膜炎。所有患者最终的 CDVA 均达到或优于 0.3 对数视力。术后并发症包括 2 只眼后发性白内障需行激光后囊切开术，4 只眼青光眼，3 只眼黄斑囊样水肿/黄斑功能障碍。术前口服泼尼松的平均剂量为 29.5mg/d，末次随访时为 8.13mg/d。中位随访时间为 6 年（5~19 年）。
这些结果表明，在充分控制眼内炎症的情况下，葡萄膜炎并不是儿童白内障手术中行 IOL 一期植入术的绝对禁忌证。
无作者在提及的任何材料或方法中有经济或私人利益。
