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Surgical management of cataract in a child with juvenile rheumatoid arthritis Mariko Iwasaki 1 , Tohru Noda 1 , Satoshi Abe 1 , Keiichiro Shimizu 1 , Kenichi Akiyama 2 1Dept of Ophthalmol, The Second Tokyo National Hosp 2Akiyama Eye Clinic pp.1245-1248
Published Date 1998/7/15
DOI https://doi.org/10.11477/mf.1410905957
  • Abstract
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A case of 8-year-old child with juvenile rheumatoid arthritis (JRA) -assocciated cataract was suc-cessfully treated with cataract surgery. She was diagnosed as monoarticular JRA at the age of 2 years. Iritis developed in the right eye 9 months later. It persisted in spite of treatment with systemic and topical corticosteroid. Iris gibbera developed at the age of 8 years. Laser iridotomy was only temporarily effective. She was referred to us for elevated intraocular pressure 4 weeks later. Her visual acuity was hand motion right and 20/20 left. The right eye showed posterior synechia and mature cataract. The left eye was normal. Cataract surgery was performed by lens aspiration after releasing the posterior synechia. Pars plana vitrectomy was performed to remove the lens capsule and anterior vitreous. The postoperative course was uneventful. The intraocular pressure had normalized with the visual acuity of 20/100 12 days later. It is suggested that complete lensectomy and meticulous anterior vitrectomy especially at the vitreous-base is essential to the treatment of JRA-associated cataract to prevent the formation of cyclitic membrane and sebsequent intractable hypotony.


Copyright © 1998, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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