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PURPOSE: To determine the incidence and risk factors for glaucoma after pediatric cataract surgery with intraocular lens (IOL) implantation. DESIGN: Retrospective, consecutive case series. METHODS: SETTING: Institutional, monocentric. STUDY POPULATION: One hundred and thirty-six children (199 eyes) that underwent pediatric cataract surgery before one year of age with a minimum of one-year follow-up. INTERVENTION: Pediatric cataract surgery with IOL implantation. MAIN OUTCOME MEASURES: Presence or absence of secondary glaucoma. RESULTS: Mean age at surgery was 148±93 days (range:30-359) with a mean follow-up of 6.3±3.6 years (range:1.1-12.8). Glaucoma developed in 31 eyes (16%) with a 5 and 10-year incidence of 12% and 28% respectively. The incidence of glaucoma seemed to be bimodal with a first peak occurring after a mean delay of 2.5 months (range:1.6-4.1 months) and a second peak occurring after a mean delay of 5.7 years (range:2.6-11.7 years). Younger age at surgery, shorter axial length, longer follow-up, use of trypan blue, reintervention and bilateral surgery were associatied with higher incidence of glaucoma. Multivariate analysis including the aforementioned variables indentified longer follow-up (odds ratio [OR] 1.3; 95% confidence interval [CI], 1.1-1.6; P=0.001), reintervention (odds ratio [OR] 4.1; 95% confidence interval [CI], 1.2-13.4; P=0.02) and use of trypan blue (odds ratio [OR] 4.1; 95% confidence interval [CI], 1.3-13.1; P=0.02) as predictors for the development of glaucoma. CONCLUSION: Glaucoma is a common complication following pediatric cataract surgery. It seemed to have a bi-modal incidence. Risk factors for glaucoma development were reintervention, use of trypan blue and long follow-up.
Fondation Ophtalmologique Rothschild, Pediatric ophthalmology department, Paris, France.
Full article9.4.11.2 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)