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Abstract #25965 Published in IGR 12-2
Aphakic glaucoma after cataract surgery for isolated nontraumatic pediatric cataract
Al-Dahmash S; Khan AOEye Contact Lens 2010; 36: 177-180
Purpose: To compare eyes diagnosed with aphakic glaucoma to those that were not after pediatric cataract surgery (age <12 years) without intraocular lens implantations for isolated (e.g., no microcornea) nontraumatic cataract with at least 5 years follow-up. Methods: Institutional retrospective institutional series (1985-2003). Results: Of 269 aphakic eyes, 62 (23%) were diagnosed with glaucoma (36 of 130 patients, 27.7%) an average of 59.0 months [m] (standard deviation (plus or minus) 44 months; median 33.5 months; range 1 to 227 months) postoperatively with an average intraocular pressure at diagnosis of 34.6 mm Hg (standard deviation (plus or minus) 5.3). Eyes diagnosed with glaucoma had lower mean age at cataract diagnosis (6.9 months versus 11.1 months) and surgery (9.2 months vs. 13.3 months), more frequent need for a second surgery to clear the visual axis (23% [8/62] versus 5.3% [11/207]), a higher percentage of eyes operated before 10 months of age (88.7% [55/62] versus 74.5% [155/207]), and a longer mean follow-up (160.4 months versus 112.7 months). The incidence of diagnosed aphakic glaucoma in eyes operated at or before 10 months of age was more than double (26.2% versus 11.9% P<0.00001). Conclusions: Independent of obvious ocular abnormality other than cataract, earlier cataract diagnosis and surgery and second surgery to clear the visual axis more frequently occurred in aphakic children who were diagnosed with aphakic glaucoma. The incidence was more than double in eyes that had surgery at or before 10 months of age. A number of cases likely have delayed diagnosis because of difficulties in assessing young patients for early glaucoma.
A. O. Khan. Division of Pediatric Ophthalmology, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh 11462, SA, Saudi Arabia.
Classification:
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)
9.4.7 Glaucomas associated with ocular trauma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
