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Ocul Immunol Inflamm. 2007 Jan-Feb;15(1):11-7.

Surgery for hypotony in patients with juvenile idiopathic arthritis-associated uveitis.

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  • 1Massachusetts Eye Research & Surgery Institute, Ocular Immunology and Uveitis Foundation, Harvard Medical School, Cambridge, MA 02142, USA.

Abstract

PURPOSE:

To describe the clinical response to cyclitic membrane excision of eyes with juvenile idiopathic arthritis (JIA)-associated uveitis and hypotony.

METHODS:

The clinical records of patients with JIA-associated uveitis in a tertiary referral center were reviewed. Those patients with JIA-associated uveitis and hypotony who underwent cyclitic membrane excision were included in the study. Patients with hypotony secondary to active inflammation, retinal detachment, and surgical intervention (filtering, cyclo-destructive procedures, and glaucoma valve implantation) were excluded.

RESULTS:

Two pediatric and two adult patients (4 eyes) were identified. The range of pre-operative intraocular pressure (IOP) was 0-5 mmHg. The two adult patients were noted to have atrophic ciliary processes intra-operatively, while the two pediatric patients had normal ciliary processes. At six months follow-up, the adult patients had IOPs of 5 mmHg, while the two pediatric patients had IOPs of 16 mmHg. At last consultation (mean duration of follow-up: 3.6 years), IOP was normal in all eyes. None of the eyes had a decrease in vision.

CONCLUSIONS:

Release of traction on the ciliary body by inflammatory membranes may play a role in the management of hypotony in patients with JIA-associated uveitis. However, even though the IOP was successfully elevated, preventing phthisis, vision remained poor due to the long-standing complications secondary to chronic uveitis. This emphasizes the critical importance of early diagnosis and appropriate treatment of the inflammation before vision-robbing complications occur.

PMID:
17365801
[PubMed - indexed for MEDLINE]
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