Phacoemulsification with Intraocular Lens Implantation in Pediatric Uveitis: A Retrospective Study

Purpose: To analyze the outcome of phacoemulsification with primary posterior chamber intraocular lens (IOL) implantation without primary posterior capsulorhexis in older children with uveitis.

Methods: Retrospective study of children with uveitis who underwent phacoemulsification with IOL implantation between January 2006 and May 2014.

Results: Twenty-one eyes of 16 children were included. Mean age at cataract surgery was 10.9 years. Juvenile idiopathic arthritis was associated in 37.5%, tuberculosis in 18.7%, Vogt Koyanagi Harada disease in 6.2%, and idiopathic uveitis in 37.5%. Anterior uveitis occurred in 8/21 eyes, intermediate uveitis in 9/21 eyes, and panuveitis in 4/21 eyes. Mean follow-up was 29.9 months. Posterior capsule opacification occurred in 15 eyes, glaucoma in two eyes, choroidal neovascular membrane in one eye, and cystoid macular edema in five eyes. At the last follow up, 19/21 eyes had improved vision and 14 had 20/40 or better vision.

Conclusion: Tight perioperative inflammatory control with immunosuppression may result in good vision after phacoemulsification and IOL implantation without posterior capsulorrhexis in older children with uveitic cataract.