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Abstract #26696 Published in IGR 12-3
Age at the time of cataract surgery and relative risk for aphakic glaucoma in nontraumatic infantile cataract without microcornea
Khan AO; Al-Dahmash SJournal of AAPOS 2009; 13: 19-20
Purpose: To report the relative risk for aphakic glaucoma as function of age at surgery in infants who underwent cataract surgery before 10 months of age for nontraumatic cataract without microcornea. Methods: Institutional retrospective case series of children who underwent cataract surgery without intraocular lens implantation for nontraumatic infantile cataract before 10 months of age. Patients with less than 5 years' postsurgical follow-up, microcornea, persistent fetal vasculature, and/or other significant anterior segment abnormality were excluded. The presence or absence of glaucoma, defined as a minimum of persistently elevated IOP (greater-than or equal to) 28 mm Hg with confirmation of the diagnosis by an attending ophthalmologist, was assessed. Results: The surgical procedure in all cases was lens aspiration, posterior capsulotomy, and anterior vitrectomy with anterior smallincision techniques. Of 210 eyes (121 patients), 55 eyes (26.2%) [31 patients (25.6%)] developed aphakic glaucoma. Relative risk for later aphakic glaucoma reached a nadir at 3-4 months of age (0.22 [95% confidence interval 0.05-0.96]). Other ages had greater relative risks (from 0.81 to 3.17) with overlapping 95% CIs. Discussion: Overlapping 95% confidence intervals of relative risk limited the ability to determine age of highest risk in our cohort. The age of surgery at lowest risk in our cohort was 3-4 months of age. Conclusions: Although there was an apparent nadir of risk for surgery at 3-4 months of age, we do not recommend delaying congenital cataract surgery longer than 4 weeks of life because of amblyopia issues.
A.O. Khan.
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)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)