INTRAOCULAR-LENS IMPLANTATION IN PATIENTS WITH JUVENILE RHEUMATOID-ARTHRITIS

PURPOSE: To study intraocular lens implantation in patients with catar acts associated with juvenile rheumatoid arthritis. METHODS: We review ed the records of seven patients (eight eyes) with juvenile rheumatoid arthritis who had undergone cataract extraction by phacoemulsificatio n with intraocular lens implantation. Initial and final visual acuitie s, preoperative and postoperative medications, and early and late comp lications were recorded. RESULTS: Posterior subcapsular cataracts and non-visually disabling peripheral band keratopathy were found in all e yes. The median postoperative follow-up was 17.5 months (mean, 16.6 mo nths; range, nine to 36 months). Five patients were adults, and two pa tients were less than 10 years old. A best-corrected visual acuity of 20/40 or better was attained in all eyes, and the last recorded visual acuity was 20/40 or better in seven of eight eyes. Early complication s included posterior synechiae formation in two eyes, one of which req uired reoperation. Late complications included visually disabling post erior capsular opacification in one eye and new glaucoma in two eyes. Preoperative corticosteroids were reduced postoperatively in five eyes , were the same in two eyes, and increased in one eye, Persistent post operative inflammation, posterior synechiae, and a pupillary membrane occurred in one of the children in this study, suggesting that intraoc ular lens implantation in this age group may have more complications. CONCLUSIONS: Results of this study suggest that, in selected adults, c ataracts caused by juvenile rheumatoid arthritis-associated uveitis ca n be treated by the standard phacoemulsification technique with intrao cular lens implantation and can have excellent results. Intraocular le ns implantation in children with juvenile rheumatoid arthritis merits further investigation.