Kulik Urszula, Wiklund Anna, Kugelberg Maria, Lundvall Anna
St. Erik Eye Hospital, Stockholm, Sweden.
Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden.
Eur J Ophthalmol. 2019 Sep;29(5):494-498. doi: 10.1177/1120672118799623. Epub 2018 Sep 12.
To evaluate the long-term outcome after cataract surgery with primary intraocular lens implantation in children with juvenile idiopathic arthritis-associated uveitis.
The medical records of all 24 children (34 eyes) with chronic juvenile idiopathic arthritis-associated uveitis who underwent cataract surgery between 1990 and 2013 were reviewed retrospectively. Primary intraocular lens implantation was performed in all patients.
Median age at diagnosis of uveitis in the first eye was 5.3 years (range: 2.7-9.4 years) and median age at the time of cataract surgery in the first eye was 9.7 years (range: 4.1-16.9 years). Postoperative follow-up time ranged from 1 to 23.1 years, with a median of 10.9 years. Best corrected visual acuity at the last follow-up was good (⩾20/40) in 65% of the eyes. Postoperatively, glaucoma developed in 8 eyes (24%), posterior capsular opacification and secondary membrane formation requiring surgery in 15 eyes (44%), macular oedema in 5 eyes (15%) and phthisis in 2 eyes (6%).
This study shows a favourable visual outcome in most of the cases. Primary intraocular lens implantation may be considered in juvenile idiopathic arthritis-associated uveitis complicated by cataract in patients with well-controlled inflammation.
评估在患有幼年特发性关节炎相关性葡萄膜炎的儿童中，白内障手术联合一期人工晶状体植入的长期效果。
回顾性分析1990年至2013年间接受白内障手术的所有24例（34只眼）患有慢性幼年特发性关节炎相关性葡萄膜炎儿童的病历。所有患者均接受了一期人工晶状体植入。
第一眼葡萄膜炎诊断时的中位年龄为5.3岁（范围：2.7 - 9.4岁），第一眼白内障手术时的中位年龄为9.7岁（范围：4.1 - 16.9岁）。术后随访时间为1至23.1年，中位时间为10.9年。最后一次随访时，65%的患眼最佳矫正视力良好（⩾20/40）。术后，8只眼（24%）发生青光眼，15只眼（44%）出现后囊膜混浊和继发性膜形成需要手术，5只眼（15%）出现黄斑水肿，2只眼（6%）出现眼球痨。
本研究表明大多数病例的视力预后良好。对于炎症得到良好控制的患有幼年特发性关节炎相关性葡萄膜炎并伴有白内障的患者，可考虑一期人工晶状体植入。
