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Suárez de Figueroa" "autores" => array:1 [ 0 => array:3 [ "nombre" => "M." "apellidos" => "Suárez de Figueroa" "email" => array:1 [ 0 => "Figueroa@servicom2000.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Hospital Universitario Ramón y Cajal, Madrid, Spain" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta de los autores" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In relation to the comments<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> on our article titled “Vitrectomy as an anti-inflammatory therapy for intermediate uveitis in children”,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> we would like to thank the interest in clarifying the best treatments for an infrequent pathology, with management always complicated due to the patients’ age, to the high recurrence rate and frequency of complications.</p><p id="par0010" class="elsevierStylePara elsevierViewall">One of the main limitations of our study is its small size, and that it is non-comparative and included only the patients who needed vitrectomy. A cohort-type study following up the evolution of all patients with intermediate uveitis could have been more illustrative about the adequate management of this pathology.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We consider that, instead of intermediate and posterior inflammation outbreaks after surgery, having recurrences expressing as anterior uveitis which can be controlled with topical treatment is a rather significant result for children in whom treatment with periocular or systemic corticoids could give rise to important long-term disorders such as the development of chronic ocular hypertension or metabolism and growth alterations. Recent publications such as “Pars plana vitrectomy in the management of paediatric uveitis: the Massachusetts Eye Research and Surgery Institution experience” or “Pars Plana Vitrectomy versus Immunomodulatory Therapy for Intermediate Uveitis: A Prospective, Randomized Pilot Study” provide additional information that endorses the usefulness of vitrectomy as an anti-inflammatory therapy for these children.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In what concerns the development of cataracts after surgery, we believe this is an acceptable risk. The Group of <span class="elsevierStyleItalic">La Paz</span> found that 11 out of 30 eyes (36.7%) with intermediate uveitis developed cataracts during the evolution of the disease, with 4 (13.3%) requiring surgery. In our view, the slightly higher rate after vitrectomy is acceptable when comparing it with the advantages afforded by said procedure.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The cases were operated on several years ago, when microincisions were not yet established. For this reason, in the discussion section of the paper we expressed our preference for less aggressive techniques instead of 20G vitrectomy.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In our experience, as described in the article, cryotherapy in the same surgical intervention over the lower 180° is enough to control the inflammatory process, although it could effectively be substituted by laser photocoagulation. However, we do not consider that periocular injection at the end of the surgery actually adds any benefits; on the contrary, it could give rise to complications such as ocular hypertension.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Actually, all the patients included in our study were intervened in the Ramón y Cajal University Hospital or in the Ophthalmological Vissum Corporation, both centers in which all the authors have worked or were trained. There is a typo in the references of authors: where it reads: “<span class="elsevierStyleSup">b</span><span class="elsevierStyleItalic">Vissum Ophthalmological Corporation, La Paz University Hospital, Madrid, Spain</span>” it should read “<span class="elsevierStyleSup">b</span><span class="elsevierStyleItalic">Vissum Ophthalmological Corporation, Madrid, Spain</span>” as only one of the authors currently works in the <span class="elsevierStyleItalic">La Paz</span> Hospital.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Suárez de Figueroa M. Respuesta de los autores. Arch Soc Esp Oftalmol. 2011;86:421–2.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "De la vitrectomía como terapia antiinflamatoria en la uveítis intermedia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Peralta-Calvo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oftal.2011.05.025" "Revista" => array:6 [ "tituloSerie" => "Arch Soc Esp Oftalmol" "fecha" => "2011" "volumen" => "86" "paginaInicial" => "421" "paginaFinal" => "422" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22117744" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pars plana vitrectomy as anti-inflammatory therapy for intermediate uveitis in children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.S. Figueroa" 1 => "S. Noval" 2 => "I. Contreras" 3 => "C. Arruabarrena" 4 => "J.L. García-Pérez" 5 => "M. Sales" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oftal.2010.10.004" "Revista" => array:6 [ "tituloSerie" => "Arch Soc Esp Oftalmol" "fecha" => "2010" "volumen" => "85" "paginaInicial" => "390" "paginaFinal" => "394" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21354506" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000008600000012/v1_201305091018/S2173579412000370/v1_201305091018/en/main.assets" "Apartado" => array:4 [ "identificador" => "8723" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000008600000012/v1_201305091018/S2173579412000370/v1_201305091018/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579412000370?idApp=UINPBA00004N" ]
Journal Information
Vol. 86. Issue 12.
Pages 421-422 (December 2011)
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Vol. 86. Issue 12.
Pages 421-422 (December 2011)
Letter to the Editor
Author's reply
Respuesta de los autores
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1760
M. Suárez de Figueroa
Hospital Universitario Ramón y Cajal, Madrid, Spain
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