Paediatric cataract in the uveitis setting
Background/aims: Cataract formation is common in uveitis and is visually more threatening in the paediatric cohort due to the risk of amblyopia. In addition, paediatric uveitis can often be difficult to manage. We report our experience with IOL placement in cataract surgery in the setting of paediat...
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| Veröffentlicht in: | European journal of ophthalmology 2021-09, Vol.31 (5), p.2651-2658 |
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| container_title | European journal of ophthalmology |
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| creator | O’Rourke, Micheal McCreery, Kathryn Kilmartin, Dara Brosnahan, Donal |
| description | Background/aims:
Cataract formation is common in uveitis and is visually more threatening in the paediatric cohort due to the risk of amblyopia. In addition, paediatric uveitis can often be difficult to manage. We report our experience with IOL placement in cataract surgery in the setting of paediatric uveitis.
Methods:
This non-comparative, retrospective interventional case series examined our cases of paediatric cataract occurring in patients with uveitis from 2003 to 2016. Parameters examined included visual acuity (VA), underlying diagnosis, immunosuppression status, intra-operative complications and requirement for further surgery.
Results:
In total, 10 eyes of seven patients were identified. The mean age at diagnosis of uveitis was 7.7 years (range 5.2–14 years) with onset of cataract at a mean of 29.3 months later (range 0–66 months). Three cases were bilateral and four cases were unilateral. Final visual outcomes were excellent with 80% showing improvement in VA achieving greater than 6/9.5 (p |
| doi_str_mv | 10.1177/1120672120962059 |
| format | Article |
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Cataract formation is common in uveitis and is visually more threatening in the paediatric cohort due to the risk of amblyopia. In addition, paediatric uveitis can often be difficult to manage. We report our experience with IOL placement in cataract surgery in the setting of paediatric uveitis.
Methods:
This non-comparative, retrospective interventional case series examined our cases of paediatric cataract occurring in patients with uveitis from 2003 to 2016. Parameters examined included visual acuity (VA), underlying diagnosis, immunosuppression status, intra-operative complications and requirement for further surgery.
Results:
In total, 10 eyes of seven patients were identified. The mean age at diagnosis of uveitis was 7.7 years (range 5.2–14 years) with onset of cataract at a mean of 29.3 months later (range 0–66 months). Three cases were bilateral and four cases were unilateral. Final visual outcomes were excellent with 80% showing improvement in VA achieving greater than 6/9.5 (p < 0.05). These patients had significant co-morbidities with concurrent glaucoma, band keratopathy and cystoid macular oedema. Uveitis was quiet for a minimum of 6 months in all cases prior to surgery with augmentation of immunosuppression pre-operatively as well as intra-operative local or intra-venous steroids. Tight post-operative care was necessary as 80% developed further flare-up of uveitis requiring increased immunosuppression and surgical interventions to manage their uveitis.
Conclusion:
Paediatric uveitis patients who develop cataract can have good visual outcomes with IOL insertion at the time of surgery when there is aggressive control of uveitis in the pre, peri and post-operative period.</description><identifier>ISSN: 1120-6721</identifier><identifier>EISSN: 1724-6016</identifier><identifier>DOI: 10.1177/1120672120962059</identifier><identifier>PMID: 33023329</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Cataract - complications ; Cataract Extraction ; Child ; Humans ; Infant ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome ; Uveitis - complications ; Uveitis - surgery ; Visual Acuity</subject><ispartof>European journal of ophthalmology, 2021-09, Vol.31 (5), p.2651-2658</ispartof><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-fe5010fcbf488adb1e145ffe650715d4561ea63234e63de296ece8e59ebb53973</citedby><cites>FETCH-LOGICAL-c337t-fe5010fcbf488adb1e145ffe650715d4561ea63234e63de296ece8e59ebb53973</cites><orcidid>0000-0001-6823-6472</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1120672120962059$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1120672120962059$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33023329$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O’Rourke, Micheal</creatorcontrib><creatorcontrib>McCreery, Kathryn</creatorcontrib><creatorcontrib>Kilmartin, Dara</creatorcontrib><creatorcontrib>Brosnahan, Donal</creatorcontrib><title>Paediatric cataract in the uveitis setting</title><title>European journal of ophthalmology</title><addtitle>Eur J Ophthalmol</addtitle><description>Background/aims:
Cataract formation is common in uveitis and is visually more threatening in the paediatric cohort due to the risk of amblyopia. In addition, paediatric uveitis can often be difficult to manage. We report our experience with IOL placement in cataract surgery in the setting of paediatric uveitis.
Methods:
This non-comparative, retrospective interventional case series examined our cases of paediatric cataract occurring in patients with uveitis from 2003 to 2016. Parameters examined included visual acuity (VA), underlying diagnosis, immunosuppression status, intra-operative complications and requirement for further surgery.
Results:
In total, 10 eyes of seven patients were identified. The mean age at diagnosis of uveitis was 7.7 years (range 5.2–14 years) with onset of cataract at a mean of 29.3 months later (range 0–66 months). Three cases were bilateral and four cases were unilateral. Final visual outcomes were excellent with 80% showing improvement in VA achieving greater than 6/9.5 (p < 0.05). These patients had significant co-morbidities with concurrent glaucoma, band keratopathy and cystoid macular oedema. Uveitis was quiet for a minimum of 6 months in all cases prior to surgery with augmentation of immunosuppression pre-operatively as well as intra-operative local or intra-venous steroids. Tight post-operative care was necessary as 80% developed further flare-up of uveitis requiring increased immunosuppression and surgical interventions to manage their uveitis.
Conclusion:
Paediatric uveitis patients who develop cataract can have good visual outcomes with IOL insertion at the time of surgery when there is aggressive control of uveitis in the pre, peri and post-operative period.</description><subject>Cataract - complications</subject><subject>Cataract Extraction</subject><subject>Child</subject><subject>Humans</subject><subject>Infant</subject><subject>Postoperative Complications</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Uveitis - complications</subject><subject>Uveitis - surgery</subject><subject>Visual Acuity</subject><issn>1120-6721</issn><issn>1724-6016</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1j0tLAzEUhYMotlb3rmTWQjQ3mSTNUoovKOhC10Mmc1NT7LQkGcF_b8qoC8HNPRfOAz5CzoFdAWh9DcCZ0rxcoziT5oBMQfOaKgbqsPzFoHt_Qk5SWjNWcjU_JhMhGBeCmym5fLbYBZtjcJWz2UbrchX6Kr9hNXxgyCFVCXMO_eqUHHn7nvDsW2fk9e72ZfFAl0_3j4ubJXVC6Ew9SgbMu9bX87ntWkCopfeoJNMgu1oqQKsEFzUq0SE3Ch3OURpsWymMFjPCxl0XtylF9M0uho2Nnw2wZo_d_MUulYuxshvaDXa_hR_OEqBjINkVNuvtEPuC8P_gF1swXkE</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>O’Rourke, Micheal</creator><creator>McCreery, Kathryn</creator><creator>Kilmartin, Dara</creator><creator>Brosnahan, Donal</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0001-6823-6472</orcidid></search><sort><creationdate>202109</creationdate><title>Paediatric cataract in the uveitis setting</title><author>O’Rourke, Micheal ; McCreery, Kathryn ; Kilmartin, Dara ; Brosnahan, Donal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-fe5010fcbf488adb1e145ffe650715d4561ea63234e63de296ece8e59ebb53973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cataract - complications</topic><topic>Cataract Extraction</topic><topic>Child</topic><topic>Humans</topic><topic>Infant</topic><topic>Postoperative Complications</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Uveitis - complications</topic><topic>Uveitis - surgery</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O’Rourke, Micheal</creatorcontrib><creatorcontrib>McCreery, Kathryn</creatorcontrib><creatorcontrib>Kilmartin, Dara</creatorcontrib><creatorcontrib>Brosnahan, Donal</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>European journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O’Rourke, Micheal</au><au>McCreery, Kathryn</au><au>Kilmartin, Dara</au><au>Brosnahan, Donal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Paediatric cataract in the uveitis setting</atitle><jtitle>European journal of ophthalmology</jtitle><addtitle>Eur J Ophthalmol</addtitle><date>2021-09</date><risdate>2021</risdate><volume>31</volume><issue>5</issue><spage>2651</spage><epage>2658</epage><pages>2651-2658</pages><issn>1120-6721</issn><eissn>1724-6016</eissn><abstract>Background/aims:
Cataract formation is common in uveitis and is visually more threatening in the paediatric cohort due to the risk of amblyopia. In addition, paediatric uveitis can often be difficult to manage. We report our experience with IOL placement in cataract surgery in the setting of paediatric uveitis.
Methods:
This non-comparative, retrospective interventional case series examined our cases of paediatric cataract occurring in patients with uveitis from 2003 to 2016. Parameters examined included visual acuity (VA), underlying diagnosis, immunosuppression status, intra-operative complications and requirement for further surgery.
Results:
In total, 10 eyes of seven patients were identified. The mean age at diagnosis of uveitis was 7.7 years (range 5.2–14 years) with onset of cataract at a mean of 29.3 months later (range 0–66 months). Three cases were bilateral and four cases were unilateral. Final visual outcomes were excellent with 80% showing improvement in VA achieving greater than 6/9.5 (p < 0.05). These patients had significant co-morbidities with concurrent glaucoma, band keratopathy and cystoid macular oedema. Uveitis was quiet for a minimum of 6 months in all cases prior to surgery with augmentation of immunosuppression pre-operatively as well as intra-operative local or intra-venous steroids. Tight post-operative care was necessary as 80% developed further flare-up of uveitis requiring increased immunosuppression and surgical interventions to manage their uveitis.
Conclusion:
Paediatric uveitis patients who develop cataract can have good visual outcomes with IOL insertion at the time of surgery when there is aggressive control of uveitis in the pre, peri and post-operative period.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>33023329</pmid><doi>10.1177/1120672120962059</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-6823-6472</orcidid></addata></record> |
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| identifier | ISSN: 1120-6721 |
| ispartof | European journal of ophthalmology, 2021-09, Vol.31 (5), p.2651-2658 |
| issn | 1120-6721 1724-6016 |
| language | eng |
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| source | MEDLINE; SAGE Complete |
| subjects | Cataract - complications Cataract Extraction Child Humans Infant Postoperative Complications Retrospective Studies Treatment Outcome Uveitis - complications Uveitis - surgery Visual Acuity |
| title | Paediatric cataract in the uveitis setting |
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