Challenges with cataract surgery in pars planitis patients

Excerpt

Children and teens with intraocular inflammation often present with cataract. It has been predicted that the risk for cataract development in children with anterior uveitis and juvenile idiopathic arthritis (JIA) is 0.16 events per patient-year of follow-up [1]. This is likely also the case for pars planitis. Pars planitis, which presents mainly in younger ages, is a subset of intermediate uveitis characterized by the presence of snowbanks at the pars plana and inflammatory cells in the vitreous. We often realize that these patients have worse vitritis, more severe macular edema and a guarded prognosis when compared to our other patients with intermediate uveitis. Indeed, cataract formation is the most frequent cause of severe vision loss in pediatric patients suffering from pars planitis, followed by vitreous opacification [2, 3]. The close proximity of inflammatory changes at the pars plana to the lens with a constant accumulation of immune mediators, as well as long term corticosteroid treatment, predispose these eyes for cataract development [4, 5]. …