Lam- Surgical management of cataracts in children with JRA uveitis
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13 years or younger had postoperative results inferior to those of adult patients and the median
follow-up was 14 months. In this study, we report the outcomes of five children (six eyes) with
JRA-associated uveitis who underwent cataract surgery with PC IOL at the Cole Eye Institute of
the Cleveland Clinic Foundation. The median follow-up was 43.5 months.
Methods
A retrospective review of the medical records of patients with juvenile rheumatoid arthritis
(JRA)-associated uveitis who underwent cataract extraction with PC IOL placement with or
without trabeculectomy at the Cleveland Clinic Foundation was performed. Only patients age
12 or younger who had follow-up longer than 15 months were included in our study. Cataract
surgery was performed when the visual acuity deteriorated to 20/100 or worse. All eyes that
underwent cataract surgery had PC IOL implantation; no eye had an AC IOL or was aphakic
after cataract surgery. Eyes underwent concurrent glaucoma filtering surgery when the
intraocular pressure was at or above 28 mmHg despite maximal medical therapy.
Data collected included age at surgery, sex, eye(s) involved, duration of uveitis prior to
surgery, duration and dose of methotrexate treatment, use of other systemic immunosuppressive
or anti-inflammatory therapy, presence of concurrent glaucoma, duration of uveitis before
glaucoma development, type of cataract, associated preoperative ocular conditions, surgery
performed, IOL implant type, frequency of pre- and postoperative corticosteroid use, pre- and
postoperative level of anterior chamber inflammation, duration of follow-up , pre- and
postoperative best corrected visual acuity and intraocular pressure (IOP), complications, and
subsequent surgical procedures. Results of laboratory evaluations, such as antinuclear antibody
