urgical management of cataract in children with juvenile rheumatoid arthriti-aociated uveiti

Purpoe To evaluate outcome of cataract urgery with poterior chamber intraocular len (IOL) implantation with or without trabeculectomy in children with juvenile rheumatoid arthriti (JRA)-aociated uveiti. Deign Interventional cae erie. Method Retropective chart review of five patient aged 12 year or younger with JRA-aociated uveiti who underwent cataract urgery with poterior chamber IOL with or without trabeculectomy at the Cleveland Clinic Foundation from December 1995 to October 2001. Reult Four female patient and one male patient ranging from age 7 to 12 year were identified. One patient had bilateral involvement; ix eye were included in the tudy. Three eye underwent cataract extraction with poterior chamber IOL, and three underwent combined cataract urgery with poterior chamber IOL and trabeculectomy. Median age at urgery wa 8.5 year, with a median follow-up of 43.5 month. Four of five children (five eye) were on ytemic methotrexate immunouppreive therapy for a median length of 1.25 year before urgery. Two of five patient (three eye) were alo on additional ytemic immunouppreive or anti-inflammatory treatment. All eye received frequent topical corticoteroid therapy for a median of 2 week preoperatively and 8.5 week potoperatively. A final potoperative nellen viual acuity of 20/40 or better wa achieved in all children. A median final viual acuity improvement of 7 nellen line wa oberved after cataract urgery. Concluion With adequate long-term preoperative and potoperative control of intraocular inflammation with ytemic immunouppreive therapy in addition to intenive topical corticoteroid treatment, children with JRA-aociated uveiti can demontrate favorable urgical outcome after cataract urgery with poterior chamber IOL.