SAN FRANCISCO — For children with uveitic cataract, the timing of surgery and the decision of whether or not to implant an IOL are paramount for successful management, according to a speaker here.
“Meticulous case selection, aggressive control of intraocular inflammation — both preoperatively and postoperatively — these are the key factors in postoperative success,” Ramesh Kekunnaya, MD, said during Pediatric Ophthalmology Subspecialty Day at the American Academy of Ophthalmology annual meeting.
Juvenile idiopathic arthritis patients with uveitic cataract should be off systemic medications for a full year before being considered a good candidate for IOL implantation, he said.
Aphakia has been the main option for these patients, but an IOL in addition to posterior capsulorrhexis and anterior vitrectomy can be performed, while hydrophobic acrylic IOLs are well tolerated. However, choosing the right patients means fully evaluating whether or not they fit certain criteria.
“A child with poor or difficult control of inflammation or compliance issues would not be good to implant the lens,” Kekunnaya said. “You have to decide on a case-to-case basis. You cannot implant in every case.”– by Rebecca L. Forand
Kekunnaya R. Uveitis and cataracts. Presented at: American Academy of Ophthalmology annual meeting; Oct. 11-15, 2019; San Francisco.
Disclosure: Kekunnaya reports no relevant financial disclosures.