First Author: S.Handa INDIA
Co Author(s): S. Singh M. Dogra P. Bajgai B. Tigari R. Singh
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To study the outcomes of epiciliary membrane removal in paediatric uveitis cases associated with complicated cataract and chronic hypotony.
Uveitis clinic of the Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India – A tertiary care referral centre in Northern India.
A retrospective chart review of paediatric patients with chronic hypotony (IOP < 6mm of Hg) due to uveitis of atleast 6 months’ duration and inactive uveitis at the time of surgery was done. All cases underwent limbal or pars plana lensectomy and pars plana vitrectomy along with epicilliary membrane removal. Assessment of ciliary body was done preoperatively by ultrasound biomicroscopy (UBM) and intraoperatively under direct visualization. Silicone oil tamponade was done in selected eyes based on the status of the ciliary processes. Main outcome measure studied were change is visual acuity and resolution of hypotony.
Seven eyes of five children (4 females, age range 4-7 years) met the inclusion criteria. All patients had juvenile idiopathic arthritis associated uveitis. Silicone oil tamponade was done is 4 eyes in which preoperative UBM demonstrated atrophy of ciliary processes. Additional procedures included BSK removal in 6 eyes. The mean follow up after the surgical procedure was 10 months. All eyes showed significant improvement in best corrected visual acuity. Mean LogMAR visual acuity preoperatively was 1.26 which improved to 0.52 postoperatively. Hypotony resolved in all the cases with the mean postoperative IOP being 14 mm of Hg from a mean of 6 mm of Hg preoperatively. No adverse events were noted during the follow up period.
Preoperative assessment with UBM followed by meticulous removal of epicilliary membrane combined with or without silicone oil tamponade can provide good functional outcome in paediatric uveitic eyes with chronic hypotony.