Chirurgie de la cataracte uvéitique non infectieuse de l’enfant : bilan des pratiques actuelles en France

Costet, C; Andrèbe, C.; Paya, Carmen; Pillet, P.; Richer, Olivier; Rougier, M.-B.; Korobelnik, Jean‐François; Coste, V.

doi:10.1016/j.jfo.2018.09.008

Cited by 1 publication

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“…Topical steroids were introduced postoperatively. Then, oral and local steroids were adapted to local inflammation [ 16 ]. In our study, the perioperative anti-inflammatory therapies were increased in all surgeries using intravascular, oral and/or local steroids.…”

Section: Discussionmentioning

confidence: 99%

Immunomodulatory treatment and surgical management of idiopathic uveitis and juvenile idiopathic arthritis-associated uveitis in children: a French survey practice

Molimard

Pajot²,

Ollé

et al. 2021

Pediatr Rheumatol

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Background Surgeries for idiopathic uveitis and juvenile idiopathic arthritis-associated uveitis in children are complex because of the high risk of inflammatory postoperative complications. There is no consensus about treatment adaptation during the perioperative period. The objectives of this study are to report the therapeutic changes made in France and to determine whether maintaining or stopping immunosuppressive therapies is associated with an increased risk of surgical site infection or an increased risk of uveitis or arthritis flare-up. Methods We conducted a retrospective cohort study between January 1, 2006 and December 31, 2018 in six large University Hospitals in France. Inclusion criteria were chronic idiopathic uveitis or chronic uveitis associated with juvenile idiopathic arthritis under immunosuppressive therapies at the time of the surgical procedure, operated before the age of 16. Data on perioperative treatments, inflammatory relapses and post-operative infections were collected. Results A total of 76 surgeries (42% cataract surgeries, 30% glaucoma surgeries and 16% posterior capsule opacification surgeries) were performed on 37 children. Adaptation protocols were different in the six hospitals. Immunosuppressive therapies were discontinued in five cases (7%) before surgery. All the children in the discontinuation group had an inflammatory relapse within 3 months after surgery compared to only 25% in the other group. There were no postoperative infections. Conclusions The results of this study show varying practices between centres. The benefit-risk balance seems to favour maintaining immunosuppressive therapies during surgery. Further studies are needed to determine the optimal perioperative treatments required to limit post-operative inflammatory relapses.

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Section: Discussionmentioning

confidence: 99%