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Abstract #10410 Published in IGR 6-1
Frequency and predictors of glaucoma after pediatric cataract surgery
Rabiah PKAmerican Journal of Ophthalmology 2004; 137: 30-37
PURPOSE: To determine the frequency of and identify predictors of chronic glaucoma after pediatric cataract surgery. DESIGN: Interventional case series. METHODS: A retrospective review at an eye hospital identified 570 eyes in 322 patients who underwent limbal-approach surgery without intraocular lens implantation at age ≤ 16 years for cataract unassociated with other ocular anomalies aside from microcornea. Patients had a minimum of five years' postoperative follow-up, which included intraocular pressure (IOP) measurement. The outcome measure was the presence or absence of postcataract surgery glaucoma, defined as IOP ≥ 26 mmHg, as measured on at least two occasions. RESULTS: Mean follow-up was 9.0 ± 3.1 years (median, 8.1 years; range, 5.0-18.3 years). Glaucoma developed in 118 of 570 patients' eyes (21%), including 101 of 272 (37%) undergoing surgery at ≤ 9 months of age and 17 of 298 (6%) undergoing surgery thereafter. Multivariable Cox proportional hazards regression analysis with adjustment for potential intrasubject correlation identified surgery at ≤ 9 months of age (hazard ratio (HR), 3.8; 95% confidence interval (CI), 1.8-7.7; p < 0.001), secondary membrane surgery (HR, 2.6; 95% CI, 1.3-5.3; p = 0.006), microcornea (HR, 1.9; 95% CI, 1.2-3.1; p = 0.008), and primary posterior capsulotomy/anterior vitrectomy (HR, 10.7; 95% CI, 1.4-80.6; p = 0.02) as predictors of glaucoma. CONCLUSIONS: Chronic glaucoma is common after cataract surgery performed at or before, but not after, a certain age in childhood. The data suggest that this age threshold is nine months, but a true threshold occurring at a somewhat later age cannot be fully excluded.
Dr. P.K. Rabiah, Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. prabiah@enh.org
Classification:
9.1.4 Other (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
