Primary cataract extraction and IOL implantation in the uveitic paediatric population

Session Details

Session Title: Paediatric Cataract Surgery

Session Date/Time: Sunday 15/09/2019 | 16:30-18:00

Paper Time: 17:36

Venue: Free Paper Forum: Podium 2

First Author: : R.Karim UK

Co Author(s): :    R. Jolly   R. Henderson   P. Sharwood   C. Edelsten                    

Abstract Details

Purpose:

Cataract surgery in the paediatric population with a history of intraocular inflammation is challenging. Uveitis can significantly impact visual development, thus its successful management is of paramount importance.

Setting:

Great Ormond Street Hospital London and Moorfields Eye Hospital London.

Methods:

A retrospective analysis of patients with uveitis who had a primary cataract extraction with phacoemulsification and primary intraocular lens implant, was carried out at two tertiary referral centres: Great Ormond Street Hospital and Moorfields Eye Hospital.

Results:

42 eyes with a mean age of IOL insertion being 10.3 years. 30 out of 42 eyes were on systemic treatment(methotrexate). 4 eyes had a final recorded visual acuity of worse than 1.0LogMar. Complications of phthisis, retinal detachment, pupillary membrane and band keratopathy. V/A in the idiopathic group of children was 0.18LogMar compared to JIA 0.36LogMar with intermediate uveitis having the worst mean visual acuity of 0.48LogMar. Glaucoma developed in 9 eyes. 4 of the eyes went on to have filtration surgery. Cumulative hazard to estimate the risk of having worse visual acuity associated with further surgeries was significant P=0.06.

Conclusions:

The study highlights good visual acuity outcomes using primary IOL implantation in uveitis patients in the paediatric population. Our results are limited by the fact that the majority of cases at Moorfields are left aphakic. With the advent of rigorous protocols, a selection of available immunotherapy and better knowledge through experience, the use of intraocular lenses has become more accepted and successful in regards to visual acuity outcomes.

Financial Disclosure:

None