Juvenile-Type Chronic Arthritis with Uveitis Cataract Surgery

Abstract

Juvenile rheumatic arthritis is a common connective tissue disease occurring at age under 16. Its main feature is chronic arthritis, accompanied by involvement of multiple systems, and the ocular manifestation is mainly uveitis. Cataract is the most common complication of juvenile chronic arthritis associated with uveitis. Despite the high success rate of cataract surgery, compared with ordinary pediatric cataract surgery, cataract surgery in patients with juvenile chronic arthritis associated with uveitis has great particularity and complexity, as reflected by such issues as how to control systemic diseases, how to control inflammation of uveitis, how to manage the perioperative stage of cataract surgery, what are the chances and treatment of postoperative complications, and what is the difference in postoperative visual acuity improvement compared with normal cataract. They are all key issues to face in patients with juvenile chronic arthritis associated with uveitis and cataracts. This section describes the differential diagnosis of juvenile chronic arthritis associated with uveitis cataract, timing of surgery, perioperative inflammation control, choice of surgical methods, and other aspects. It suggests that the ophthalmologist should, on the basis of precise diagnosis, take into account the concomitant treatment of systemic diseases according to patient age, diagnosis, and inflammation severity, to improve the prognosis of cataract surgery for the patients with juvenile chronic arthritis associated with uveitis. It can help the ophthalmologist establish personalized cataract surgery treatment protocols that specifically address the key points of “rheumatic immune disease,” “uveitis,” and “juvenile.”