Langner-Wegscheider BJ, de Smet MD. Surgical management of severe complications arising from uveitis in juvenile idiopathic arthritis.
Ophthalmologica 2014;
232:179-86. [PMID:
25342480 DOI:
10.1159/000365230]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 06/12/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE
Evaluate outcomes from severe ocular complications of juvenile idiopathic arthritis following surgery.
METHODS
Eleven eyes of 7 patients underwent complete vitrectomy and peeling of the inner limiting membrane. Inclusion criteria were: anteroposterior segment involvement, hypotony, inflammation control of less than 3 months, compliance issues, rapidly progressive disease. Phacoemulsification was allowed if the patient was >6 years old and inflammation free >3 months. The alternative was a complete lensectomy.
RESULTS
Visual acuity improved from a logMAR of 1.48 to 0.37 (p < 0.0001), and 0.20 at 6 and 12 months (p < 0.0001). No flare-up was observed within the first 6 months. Five eyes developed inflammation between 7 and 19 months. Glaucoma developed in 5 eyes at a median of 16 months. No patient developed cystoid macular edema.
CONCLUSION
Extensive pars plana vitrectomy and cataract extraction can lead to significant improvement in visual acuity. Patients continue to require long-term immunosuppression and adequate follow-up.
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