Kataraktchirurgie bei Uveitis im Kindesalter

Zusammenfassung

Die Kataraktentwicklung ist die häufigste visusrelevante Komplikation bei Uveitis im Kindesalter. Eine Kataraktoperation beinhaltet hier besondere Risiken für intra- und postoperative Komplikationen und erfordert eine intensive perioperative Immunsuppression, eine möglichst atraumatische Operation am reizfreien Auge und eine konsequente Therapie der Amblyopie. Werden diese Faktoren beachtet, erlaubt eine rechtzeitige Kataraktoperation auch bei Uveitis im Kindesalter eine anhaltende visuelle Rehabilitation.

Abstract

The development of cataract is the most frequent vision-threatening complication of uveitis in children. In such cases cataract surgery is associated with a particular risk of intra- and postoperative complications and requires an intensive perioperative immunosuppression, an essentially atraumatic operation in a quiscient eye, and aggressive amblyopia treatment. When these factors are taken into consideration, a timely cataract operation can result in a sustained visual rehabilitation even for children with uveitis.

Schlüsselwörter

Katarakt - Uveitis - IOL Implantation

Key words

cataract - uveitis - IOL implantation

Literatur

• 1 Abela-Formanek C, Amon M, Schauersberger J. et al . Results of hydrophilic acrylic, hydrophobic acrylic, and silicone intraocular lenses in uveitic eyes with cataract: Comparison to a control group.  J Cataract Refrac Surg. 2002;  28 1141-1152
• 2 Abela-Formanek C, Amon M, Schauersberger J. et al . Uveal and capsular biocompatibility of 2 foldable acrylic intraocular lenses in patients with uveitis or pseudoexfoliation syndrome: comparison to a control group.  J Cataract Refract Surg. 2002;  28 1160-1161
• 3 Alio J L, Chipont E, BenEzra D. et al . Comparative performance of intraocular lenses in eyes with cataract and uveitis.  J Cataract Refract Surg. 2002;  28 2096-2108
• 4 BenEzra D, Cohen E. Cataract surgery in children with chronic uveitis.  Ophthalmology. 2000;  107 1255-1260
• 5 Foster C S, Barrett F. Cataract development and cataract surgery with juvenile rheumatoid arthritis-associated iridocyclitis.  Ophthalmology. 1993;  100 809-817
• 6 Fox G M, Flynn H W, Davis J L. 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;  114 708-714
• 7 Häberle Jr H, Velhagen K H, Pleyer U. Pseudophakie bei Kindern mit juveniler Arthritis.  Ophthalmologe. 1998;  95 823-827
• 8 Heiligenhaus A, Niewerth M, Mingels A. et al . Epidemiologische Daten zur Uveitis bei juveniler idiopathischer Arthritis aus einer bundesweiten pädiatrischen und ophthalmologischen Datenerhebung (Uveitis-Modul der Kerndokumentation).  Klin Monatsbl Augenheilkd. 2005;  222 993-1001
• 9 Heiligenhaus A, Heinz C, Becker M. The treatment of uveitis cataract. Kohnen T, Koch D Cataract and Refractive Surgery Springer 2005: 133-152
• 10 Hiles D A. Visual acuities of monocular IOL and non-IOL aphakic children.  Ophthalmology. 1980;  87 1296-1300
• 11 Kanski J J. Lensectomy for complicated cataract in juvenile chonic iridocyclitis.  Br J Ophthalmol. 1992;  76 72-75
• 12 Klais C M, Hattenbach L O, Steinkamp G WK. et al . Intraocular recombinant tissue-plasminogen activator fibrinolysis of fibrin formation after cataract surgery in children.  J Cataract Refract Surg. 1999;  25 357-362
• 13 Kohnen T, Dick B, Hessemer V. et al . Effect of heparin in irrigating solution on inflammation following small incision cataract surgery.  J Cataract Refract Surg. 1998;  24 237-243
• 14 Kotaniemi K, Penttila H. Intraocular lens implantation in patients with juvenile idiopathic arthritis-associated uveitis.  Ophthalmic Res. 2006;  38 318-323
• 15 Lam L A, Lowder C Y, Baerveldt G. et al . Surgical management of cataracts in children with juvenile rheumatoid arthritis-associated uveitis.  Am J Ophthalmol. 2003;  135 772-778
• 16 Lardenoye C W, Kooij van B, Rothova A. Impact of macular edema on visual acuity in uveitis.  Ophthalmology. 2006;  113 1446-1449
• 17 Li J, Heinz C, Zurek-Imhoff B. et al . Intraoperative intraocular triamcinolone injection prophylaxis for post-cataract surgery fibrin formation in uveitis associated with juvenile idiopathic arthritis.  J Cataract Refract Surg. 2006;  32 1535-1539
• 18 Lundvall A, Zetterström C. Cataract extraction and intraocular lens implantation in children with uveitis.  Br J Ophthalmol. 2000;  84 791-793
• 19 Matsuo T, Takahashi M, Inoue Y. et al . Ocular attacks after phacoemulsification and intraocular lens implantation in patients with Behcet’s disease.  Ophthalmologica. 2001;  215 179-182
• 20 Mondino B J, Nagata S, Glovsky M M. Activation of the alternative complement pathway by intraocular lenses.  Invest Ophthalmol Vis Sci. 1985;  26 905-908
• 21 Nemet A Y, Raz J, Sachs D. et al . Primary intraocular lens implantation in pediatric uveitis: a comparison of 2 populations.  Arch Ophthalmol. 2007;  125 354-360
• 22 Paikos P, Fotopoulou M, Papathanassiou M. et al . Cataract surgery in children with uveitis.  J Pediatr Ophthalmol Strabismus. 2001;  38 16-20
• 23 Probst L E, Holland E J. Intraocular lens implantation in patients with juvenile rheumatoid arthritis.  Am J Ophthalmol. 1996;  122 161-170
• 24 Rosenberg K D, Feuer W J, Davis J L. Ocular complications of pediatric uveitis.  Ophthalmology. 2004;  111 2299-2306
• 25 Rumelt S, Stolovich C, Segal Z I. et al . Intraoperative enoxaparin minimizes inflammatory reaction after pediatric cataract surgery.  Am J Ophthalmol. 2006;  141 433-437
• 26 Saika S. Relationship between posterior capsule opacification and intraocular lens biocompatibility.  Prog Ret Eye Res. 2004;  23 283-305
• 27 Schild G, Schauersberger J, Amon M. et al . Lens epithelial cell ongrowth: comparison of 6 types of hydrophilic intraocular lens models.  J Cataract Refract Surg. 2005;  31 2375-2378