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Juvenile-Type Chronic Arthritis with Uveitis Cataract Surgery

  • Hong Lu
  • Ying Hong
Chapter
Part of the Advances in Visual Science and Eye Diseases book series (AVSED, volume 3)

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.”

References

  1. 1.
    Rojas B, Zafirakis P, Foster CS. Cataract surgery in patients with uveitis. Curr Opin Ophthalmol. 1997;8(1):6–12.CrossRefPubMedGoogle Scholar
  2. 2.
    Belair ML, Kim SJ, Thorne JE, et al. Incidence of cystoid macular edema after cataract surgery in patients with and without uveitis using optical coherence tomography. Am J Ophthalmol. 2009;148(1):128–35.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Matsuo T, Takahashi M, Inoue Y, et al. Ocular attacks after phacoemulsification and intraocular lens implantation in patients with Behcet disease. Ophthalmologica. 2001;215(3):179–82.CrossRefPubMedGoogle Scholar
  4. 4.
    Adan A, Gris O, Pelegrin L, et al. Explantation of intraocular lenses in children with juvenile idiopathic arthritis-associated uveitis. J Cataract Refract Surg. 2009;35(3):603–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Terrada C, Julian K, Cassoux N, et al. Cataract surgery with primary intraocular lens implantation in children with uveitis: long-term outcomes. J Cataract Refract Surg. 2011;37(11):1977–83.CrossRefPubMedGoogle Scholar
  6. 6.
    Lam LA, Lowder CY, Baerveldt G, et al. Surgical management of cataracts in children with juvenile rheumatoid arthritis-associated uveitis. Am J Ophthalmol. 2003;135(6):772–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Probst LE, Holland EJ. Intraocular lens implantation in patients with juvenile rheumatoid arthritis. Am J Ophthalmol. 1996;122(2):161–70.CrossRefPubMedGoogle Scholar
  8. 8.
    Nemet AY, Raz J, Sachs D, et al. Primary intraocular lens implantation in pediatric uveitis: a comparison of 2 populations. Arch Ophthalmol. 2007;125(3):354–60.CrossRefPubMedGoogle Scholar
  9. 9.
    Oren B, Sehgal A, Simon JW, et al. The prevalence of uveitis in juvenile rheumatoid arthritis. J AAPOS. 2001;5(1):2–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Benezra D, Cohen E. Cataract surgery in children with chronic uveitis. Ophthalmology. 2000;107(7):1255–60.CrossRefPubMedGoogle Scholar
  11. 11.
    Quinones K, Cervantes-Castaneda RA, Hynes AY, et al. Outcomes of cataract surgery in children with chronic uveitis. J Cataract Refract Surg. 2009;35(4):725–31.CrossRefPubMedGoogle Scholar
  12. 12.
    Jonas JB. Intravitreal triamcinolone acetonide: a change in a paradigm. Ophthalmic Res. 2006;38(4):218–45.CrossRefPubMedGoogle Scholar
  13. 13.
    Okhravi N, Morris A, Kok HS, et al. Intraoperative use of intravitreal triamcinolone in uveitic eyes having cataract surgery: pilot study. J Cataract Refract Surg. 2007;33(7):1278–83.CrossRefPubMedGoogle Scholar
  14. 14.
    Dada T, Dhawan M, Garg S, et al. Safety and efficacy of intraoperative intravitreal injection of triamcinolone acetonide injection after phacoemulsification in cases of uveitic cataract. J Cataract Refract Surg. 2007;33(9):1613–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Foster CS, Barrett F. Cataract development and cataract surgery in patients with juvenile rheumatoid arthritis-associated iridocyclitis. Ophthalmology. 1993;100(6):809–17.CrossRefPubMedGoogle Scholar
  16. 16.
    Kanski JJ. Juvenile arthritis and uveitis. Surv Ophthalmol. 1990;34(4):253–67.CrossRefPubMedGoogle Scholar
  17. 17.
    Hooper PL, Rao NA, Smith RE. Cataract extraction in uveitis patients. Surv Ophthalmol. 1990;35(2):120–44.CrossRefPubMedGoogle Scholar
  18. 18.
    Foster CS, Fong LP, Singh G. Cataract surgery and intraocular lens implantation in patients with uveitis. Ophthalmology. 1989;96(3):281–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Flynn HW Jr, Davis JL, Culbertson MW. Pars plana lensectomy and vitrectomy for complicated cataracts in juvenile rheumatoid arthritis. Ophthalmology. 1988;95(8):1114–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Kanski JJ, Shun Shin GA. Systemic uveitis syndromes in childhood: an analysis of 340 cases. Ophthalmology. 1984;91(10):1247–52.CrossRefPubMedGoogle Scholar
  21. 21.
    Holland GN. Intraocular lens implantation in patients with juvenile rheumatoid arthritis-associated uveitis: an unresolved management issue. Am J Ophthalmol. 1996;122(2):255–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Fox GM, Flynn HW Jr, Davis JL, et al. Causes of reduced visual acuity on long-term follow-up after cataract extraction in patients with uveitis and juvenile rheumatoid arthritis. Am J Ophthalmol. 1992;114(6):708–14.CrossRefPubMedGoogle Scholar
  23. 23.
    Wolf MD, Lichter RR, Ragsdale CG. Prognostic factors in the uveitis of juvenile rheumatoid arthritis. Ophthalmology. 1987;94(10):1242–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Tessler HH, Farber MD. Intraocular lens implantation versus no intraocular lens implantation in patients with chronic iridocyclitis and pars planitis: a randomized prospective study. Ophthalmology. 1993;100(8):1206–9.CrossRefPubMedGoogle Scholar
  25. 25.
    Alio JL, Chipont E, Benezra D, et al. Comparative performance of intraocular lenses in eyes with cataract and uveitis. J Cataract Refract Surg. 2002;28(12):2096–108.CrossRefPubMedGoogle Scholar
  26. 26.
    Tomlins PJ, Sivaraj RR, Rauz S, et al. Long-term biocompatibility and visual outcomes of a hydrophilic acrylic intraocular lens in patients with uveitis. J Cataract Refract Surg. 2014;40(4):618–25.CrossRefPubMedGoogle Scholar
  27. 27.
    Abela-Formanek C, Amon M, Kahraman G, et al. Biocompatibility of hydrophilic acrylic, hydrophobic acrylic, and silicone intraocular lenses in eyes with uveitis having cataract surgery: long-term follow-up. J Cataract Refract Surg. 2011;37(1):104–12.CrossRefPubMedGoogle Scholar
  28. 28.
    de Boer J, Wulffraat N, Rothova A. Visual loss in uveitis of childhood. Br J Ophthalmol. 2003;87(7):879–84.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. and People's Medical Publishing House, PR of China 2020

Authors and Affiliations

  • Hong Lu
    • 1
  • Ying Hong
    • 2
  1. 1.Department of OphthalmologyBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
  2. 2.Department of OphthalmologyPeking University Third HospitalBeijingChina

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