title: Controversies in intraocular lens implantation in pediatric uveitis.
abstract: Cataract is one of the most common and visually debilitating complications of pediatric uveitis. It develops as a consequence of chronic inflammation and steroid use and is seen most often in juvenile idiopathic arthritis (JIA)-associated uveitis. Cataract extraction with intraocular lens (IOL) insertion has been carried out with a measure of success in non-uveitic pediatric eyes, but in cases of uveitis, multiple factors affect the final outcome. Chronic inflammation and its sequelae such as band keratopathy, posterior synechiae, and cyclitic membranes make surgical intervention more challenging and outcome less certain. Postoperative complications like increased inflammation, glaucoma, posterior capsular opacification, retrolental membranes, and hypotony may compromise the visual outcome. Early refractive correction is imperative in pediatric eyes to prevent amblyopia. The use of contact lenses and intraocular lenses in pediatric uveitic eyes were fraught with complications in the past. Surgical interventions such as vitreo-lensectomy followed by contact lens fitting and small incision cataract surgery followed by different types of intraocular lenses have been utilized, and many reports have been published, albeit in small patient groups. This review analyzes and discusses the existing literature on intraocular lens implantation in cases of pediatric uveitic cataract surgery.
authors.affiliation: Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK. sumita.phatak@gmail.com.
authors.forename: Sumita
authors.identifier: http://orcid.org/0000-0002-5899-0882
authors.initials: S
authors.lastname: Phatak
authors.affiliation: Cleveland Clinic Cole Eye Institute, 9500 Euclid Ave, Cleveland, OH, 44106, USA.
authors.forename: Careen
authors.initials: C
authors.lastname: Lowder
authors.affiliation: Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK.|Inflammation and Immunotherapy Theme, National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, London, EC1V 2PD, UK.
authors.forename: Carlos
authors.initials: C
authors.lastname: Pavesio
keywords: Chronic uveitis; Complicated cataract; Intraocular lenses; Pediatric uveitis; Uveitic cataract