Frequency and determinants of postoperative fibrinous uveitis after paediatric cataract surgery at a tertiary hospital in southwest Nigeria

Povzetek

Aims: To determine the occurrence and risk factors of fibrinous uveitis following paediatric cataract surgery.

Methods: This was a retrospective interventional study of children aged less than 16 years who underwent cataract surgery at the University College Hospital, Ibadan, Nigeria between January
2008 and December 2012. Case records of eligible patients were reviewed and patients with missing or incomplete records were excluded. Information retrieved included age at presentation
and at surgery, type of childhood cataract, morphology of the cataract, type of surgery performed, occurrence of fibrinous uveitis, and final visual outcome.

Results: A total of 197 eyes of 137 children were studied. Eight-six (62.8%) were boys. The mean age at the time of surgery was 76.1 (±50.5) months. A total of 126 (64.0%) eyes underwent cataract surgery with implantation of polymethylmethacrylate intraocular lens. Seventy (35.5%) eyes had fibrinous uveitis; 15 (21.4%) of these eyes subsequently developed optic capture of intraocular lens. Older age at presentation, older age at surgery, uveitic cataracts, traumatic cataracts and intraocular lens implantation were associated with fibrinous uveitis in bivariate analyses. With logistic regression analysis, however, only intraocular lens implantation was found to be associated with fibrinous uveitis.

Conclusion: Fibrinous uveitis is a relatively common complication of paediatric cataract surgery in our setting. Implantation of polymethylmethacrylate intraocular lens is a significant risk factor for fibrinous uveitis after paediatric cataract surgery.

Keywords: Paediatric cataract, surgery, fibrinous uveitis, Nigeria

Résumé
Objectifs: Déterminer la présence et les facteurs de risque d’uvéite fibrineuse après une chirurgie de la cataracte pédiatrique.

Méthodes: Il s’agissait d’une étude rétrospective portant sur l’intervention d’enfants âgés de moins de 16 ans ayant subi une opération de la cataracte auCollège Hospitalier Universitaire d’Ibadan (Nigéria) entre janvier 2008 et décembre 2012. Les dossiers de patients éligibles ont été examinés et les patients, avec information manquante ou incomplète, exclus. Les informations
récupérées comprenaient l’âge au moment de la présentation et à la chirurgie, le type de cataracte infantile, la morphologie de la cataracte, le type de chirurgie adoptée, la survenue d’une uvéite fibrineuse et le résultat visuel final.

Résultats:  Au total, 197 yeux de 137 enfants ont été étudiés. Quatre-vingt-six (62,8%) étaient des garçons. L’âge moyen au moment de la chirurgie était de 76,1 (± 50,5) mois. Au total, 126 yeux (64,0%) ont subi une chirurgie de la cataracte avec implantation d’une lentille intraoculaire en polyméthylméthacrylate. Soixante-dix (35,5%) des yeux avaient une uvéite fibrineuse ; 15 (21,4%) de ces yeux ont par la suite développé une capture optique de la lentille intraoculaire.Un âge plus élevé  \ au moment de la présentation, un âge plus avancé au moment de la chirurgie, la cataracteuvéitique, la cataracte traumatique et l’implantation de la lentille intraoculaire étaient associés à une uvéite fibrineuse lors des analyses bivariés.Avec l’analyse de régression logistique, cependant, seule l’implantation d’une lentille intraoculaire a été associée à une uvéite fibrineuse.

Conclusion: L’uvéite fibrineuse est une complication relativement fréquente de la chirurgie de la cataracte pédiatriquedans notre location.L’implantation d’une lentille intraoculaire en polyméthylméthacrylate est un facteur de risque important d’uvéite fibrineuse après une chirurgie de la cataracte pédiatrique.

Mots - clés: cataracte pédiatrique, uvéite fibrineuse, chirurgie, Nigéria

Correspondence: Dr. B.A. Olusanya, Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail: bolutife@yahoo.com; bolusanya@comui.edu.ng

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