Risk factors for glaucoma after infant cataract surgery


A total of 212 patients (319 eyes) were included in the analysis. The investigators reported that the mean age of patients at cataract surgery was 50 days (range, 11–325 days) and the median follow-up was 8.8 years (range, 1–26.3 years). (Adobe Stock/ND STOCK)

The true incidence of glaucoma development after pediatric patients undergoing cataract surgery is unknown and ranges from 8% to 59%.

In this recent study, Bharti Nihalani-Gangwani, M.D., Ph.D., Department of Ophthalmology, Children’s Hospital, and Deborah VanderVeen, M.D., Ph.D., Department of Ophthalmology, Harvard Medical School in Boston, reported that 29% of a large cohort of infants developed glaucoma. and risk factors at the annual meeting of the American Society for Cataract and Refractive Surgery.

Researchers conducted a chart review of patients over 30 years. Inclusion criteria included at least 1 year of follow-up. In this study, glaucoma was defined as changes in intraocular pressure and optic nerve head >25 mmHg on two consecutive visits.

Dr. Nihalani-Gangwani and Dr. VanderVeen assessed the age of patients at the time of cataract surgery. presence of a microcornea, defined as a corneal diameter less than 9 mm); cataract morphology, time to glaucoma onset after cataract surgery, and type of treatment.

Chart review result

A total of 212 patients (319 eyes) were included in the analysis. The investigators reported that the mean age of patients at cataract surgery was 50 days (range, 11–325 days) and the median follow-up was 8.8 years (range, 1–26.3 years).

They found a 29% incidence of postoperative glaucoma in this cohort of children.

In 82% of eyes with postoperative glaucoma, patients were younger than 3 months at the time of surgery (p=0.001). Other factors associated with the development of glaucoma included the presence of microcornea (44%, p<0.0001), poor pupillary dilation (10%, p=0.004), persistence of fetal vasculature (12%, p=0.8). ), and anterior segment dysplasia (3%, p=0.02), the authors reported.

In addition, 76% of patients who developed glaucoma within one year after cataract surgery required surgical intervention, compared with 13% of patients who developed glaucoma more than one year after cataract surgery. was also found to be significant (p=0.0002). In the latter group, 87% of treatments were effective in controlling late-onset glaucoma.

The study yielded a 29% incidence of glaucoma after cataract surgery, with major risk factors including young age at surgery, presence of microcorneas, and poor pupil dilation. rice field.

A related finding is that patients with early-onset glaucoma are more likely to require surgery, whereas later-onset glaucoma responded to medical therapy in a high percentage of patients.



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