PURPOSE: To identify the possible risk factors for the development of cataract 
requiring surgery in children with juvenile idiopathic arthritis 
(JIA)-associated uveitis.
DESIGN: Retrospective cohort study.
METHODS: Data of 53 children with JIA-associated uveitis, of whom 27 had 
undergone cataract extraction (CE), were obtained. The main outcome measure, the 
interval between the onset of uveitis and the first CE (U-CE interval), was 
examined in relation to clinical and ophthalmologic characteristics and 
treatment strategies before CE.
RESULTS: A shorter U-CE interval was found for children with posterior synechia 
vs those without posterior synechia (hazard ratio [HR], 3.57; 95% confidence 
interval [CI], 1.33 to 10.00). No significant difference was found for children 
in whom the uveitis was the first manifestation of JIA vs those in whom 
arthritis was the first manifestation of JIA (HR, 1.59; 95% CI, 0.63 to 4.00) 
and children treated with periocular corticosteroid injections vs those not 
treated with periocular corticosteroid injections (HR, 3.23; 95% CI, 0.95 to 
11.11). Children treated with methotrexate (MTX) had a longer U-CE interval than 
children not treated with MTX (HR, 0.29; 95% CI, 0.10 to 0.87).
CONCLUSIONS: The risk factor for development of early cataract requiring surgery 
in children with JIA-associated uveitis is the presence of posterior synechia at 
the time of diagnosis of uveitis. However, early treatment with MTX is 
associated with a mean delay in the development of cataract requiring surgery of 
3.5 years.