Lam- Surgical management of cataracts in children with JRA uveitis
11
this study developed such opacification which is comparable to the rates found by Lundvall and
Zetterstrom
10
(70%, 7 of 10 eyes), BenEzra and Cohen
11
(80%, 4 of 5 eyes) and Probst and
Holland
12
(100%, 3 of 3 pediatric eyes). In our study, a single Nd:Yag capsulotomy was required
in five of six (83%) eyes. Only one eye (17%) required a subsequent surgical posterior
capsulectomy and vitrectomy for marked proliferation of Elschnig pearls. Other studies
10,11
reported numerous reoperations for retrolental membranes. Three of five eyes (60%) in the
study by BenEzra and Cohen
11
and three of ten eyes (30%) in the study by Lundvall and
Zetterstrom
10
underwent one or more surgeries for removal of secondary membranes. The lower
rates of reoperations reported in both our study and that of Lundvall and Zetterstrom
10
likely
reflect the effect of long-term topical and systemic immunosuppressive medication use.
Another frequently reported postoperative complication after cataract surgery in children
with uveitis is posterior synechia. Posterior synechiae developed in 100% and 66%,
respectively, of the eyes with JRA uveitis and PC IOL in studies by BenEzra and Cohen
11
and
Probst and Holland.
12
In contrast, we did not find any posterior synechiae at final follow-up
(median, 43.5 months) among the eyes in our study.
The frequency of glaucoma in our study was comparable to previous reports.
10,11,12
In this
study, five of six eyes (83%) developed glaucoma during the study period. Sixty percent (6 of
10) of eyes in the study by Lundvall and Zetterstrom
10
developed glaucoma, while 56% (5 of 9)
of eyes in the study by BenEzra and Cohen
11
had glaucoma during the study period.
10,11
All
eyes (3 of 3) had glaucoma in the study by Probst and Holland.
12
Patient C had early failure of her filtering bleb 5 weeks after surgery and she was the only
child not on systemic immunosuppressive therapy in this study. Eye 5 in another child required
one glaucoma medication at 33 months postoperatively. Similarly, the eye in the study by
