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Abstract #52426 Published in IGR 15-1
Incidence and predictors of glaucoma following surgery for congenital cataract in the first year of life in Victoria, Australia
Ruddle JB; Staffieri SE; Crowston JG; Sherwin JC; Mackey DAClinical and Experimental Ophthalmology 2013; 41: 653-661
BACKGROUND: To determine the incidence and predictors of glaucoma following surgery for congenital and infantile cataract in an Australian population DESIGN: Retrospective cohort study PARTICIPANTS: Infants (age <12 months) during lens extraction between January 1992 and May 2006, from two tertiary referral centres METHODS: Children with uveitis, anterior segment dysgenesis, aniridia, retinopathy of prematurity, and lens subluxation were excluded. Potential predictors of incident glaucoma were examined using Cox proportional hazards regression with adjustment for clustering between eyes. MAIN OUTCOME MEASURES: Incidence and predictors of secondary glaucoma RESULTS: 147 eyes of 101 patients (46 bilateral cataract; 55 unilateral cataract) were included, with median follow-up of 9.9 years (range 1.2 - 18.9 years). Cumulative incidence of glaucoma was 32.0% for eyes (N=47) and 30.7% (N=31) for subjects. Incidence was higher in children with bilateral cataract (38.9 vs. 17.1%, P=0.004). There were 3.9 cases of glaucoma per 100 person years of follow-up, and the incidence rate was highest for surgery performed in the first month of life. Children with glaucoma had longer median follow-up (11.8 vs. 9.3 years, P=0.005). Risk of glaucoma decreased with increasing months of age at operation: hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.69 - 0.91, P=0.001. Median visual acuity was worse in children with unilateral cataract (P<0.001) CONCLUSIONS: We identified an increased risk of glaucoma when cataract surgery was performed in younger infants, and in those with bilateral cataract. As glaucoma may develop over a decade following lens extraction, all patients require life-long surveillance following cataract surgery to prevent glaucoma-associated vision loss.
Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, 3002.
Full articleClassification:
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
9.4.4.2 Glaucomas associated with cataracts (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
1.1 Epidemiology (Part of: 1 General aspects)