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Abstract #5756 Published in IGR 2-1
Does primary intraocular lens implantation prevent 'aphakic' glaucoma in children?
Asrani S; Freedman S; Hasselblad V; Buckley EG; Egbert J; Dahan E; Gimbel H; Johnson D; McClatchey S; Parks MJournal of AAPOS 2000; 4:33-39
PURPOSE: Open-angle glaucoma may develop after surgery for congenital or developmental cataract with an incidence ranging from 3% to 41%. The pathogenesis of 'aphakic' (open-angle) glaucoma remains unknown. Despite numerous reported clinical series (>1000 eyes), the authors are unaware of any reported case of open-angle glaucoma after primary intraocular lens (IOL) implantation for congenital or developmental cataract. They decided to test the hypothesis that primary posterior chamber IOL implantation might decrease the incidence of open-angle glaucoma in children. METHODS: Pseudophakic eyes were collected from surgeons who contributed data to a refractive study and who monitored intraocular pressure on a regular basis. IOL implantation was commonly performed in eyes with a corneal diameter >10 mm. Comparable primary data on aphakic eyes were included from two published studies on aphakic glaucoma, which included corneal diameters and the patient's age at surgery. Glaucoma-free survival estimates for each cohort were estimated. RESULTS: Only one case of glaucoma was found among 377 eyes with primary pseudophakia (mean age of patients, 5.1±4.7 years; mean follow-up, 3.9±2.7 years). There were 14 eyes (11.3%) with glaucoma among 124 aphakic eyes (mean age of patient, 2.7±2.6 years; mean follow-up time, 7.2±3.9 years). CONCLUSIONS: The authors report a decreased incidence of open-angle glaucoma among eyes rendered primarily pseudophakic compared with those that remained aphakic after cataract surgery. They propose two theories on the possible mechanism of reduction in the incidence of glaucoma in pseudophakic eyes.
Dr. S. Asrani, Duke University Eye Center and the Duke Clinical Research Center, Durham, NC, USA
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)
12.12.2 Extracapsular (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
