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Aphakic glaucoma after congenital cataract surgery.
Teresa C Chen1, David S Walton, Lini S Bhatia
1Glaucoma Service, Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston 02114, USA. teresa_chen@meei.harvard.edu
Archives of Ophthalmology (Chicago, Ill. : 1960)
|December 15, 2004
Summary
Aphakic glaucoma following lensectomy for congenital cataracts is often open-angle type. This condition requires lifelong monitoring due to a guarded prognosis and the need for glaucoma surgery in many cases.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Glaucoma Research
Background:
- Congenital cataracts are a significant cause of vision impairment in children.
- Lensectomy is a common surgical procedure for congenital cataracts.
- Aphakic glaucoma is a serious complication that can arise after lensectomy.
Purpose of the Study:
- To present the largest series of patients diagnosed with aphakic glaucoma after lensectomy for congenital cataracts.
- To analyze the characteristics, outcomes, and risk factors associated with this condition.
Main Methods:
- Retrospective review of patients managed by a pediatric glaucoma specialist from 1970 to 2002.
- Inclusion criteria: intraocular pressure > 25 mm Hg post-lensectomy, exclusion of pre-existing glaucoma or associated conditions.
- Study included 170 eyes from 117 patients with a mean follow-up of 8.6 years.
Main Results:
- The majority of congenital cataracts were complete (40.8%) or nuclear (22.5%).
- Lensectomies were performed before age 1 in 80.6% of eyes, with glaucoma onset often within the first year.
- Open-angle glaucoma was prevalent (93.9% of eyes with gonioscopy), and 57.1% required glaucoma surgery; median visual acuity was 20/400.
Conclusions:
- Aphakic glaucoma post-congenital cataract surgery is predominantly of the open-angle type.
- The prognosis for visual acuity is guarded, necessitating vigilant, lifelong follow-up.
- Identification of risk factors and early screening are crucial for managing this complication.