Predictors of glaucoma following cataract surgery in children

  • Solebo AL & al.
  • Br J Ophthalmol
  • 5 Oct 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Both younger age at surgery (the strongest marker of ocular ‘immaturity’) and smaller ocular size (a marker of both immaturity and developmental vulnerability) independently predict the risk for glaucoma because of early-life cataract surgery.

Why this matters

  • Longer term follow-up of this cohort, and evaluation of anatomical differences between those free of glaucoma, those with ocular hypertension, and with early vs late-onset glaucoma, should enable greater understanding of this disorder.

Study design

  • IoLunder2 study of 235 children (≤2 years) who underwent cataract surgery between January 2009 and December 2010.
  • Glaucoma-related adverse events, potential predictors of secondary glaucoma and outcomes following unilateral and bilateral cataract surgery were evaluated.
  • Funding: Department of Health’s National Institute for Health Research Biomedical Research Centre.

Key results

  • By the end of the 5th postoperative year, 105 of 370 eyes (28.4%) had developed glaucoma, ocular hypertension, or pupil block.
  • 47 operated eyes (12.8%) of 39 children had secondary glaucoma and 35 operated eyes (20.6%) of 28 children had persistent ocular hypertension.
  • Factor independently associated with the risk for postoperative glaucoma included:
    • younger age at surgery (OR, 1.12; 95% CI, 1.05-1.18; P<.001>
    • significant ocular comorbidity (OR, 3.20; 95% CI, 1.06-9.63; P=.04),
    • decreasing axial length (OR, 1.36; 95% CI, 1.01-1.90; P=.05)
  • Shorter axial length (

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