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The aetiology in paediatric aphakic glaucoma

F Koc1, S Kargi, A W Biglan

  • 1SB Ankara Eye Hospital, Ankara, Turkey. dr_feray@yahoo.com

Eye (London, England)
|November 15, 2005
PubMed

Insights

Pediatric glaucoma can arise from cataract surgery, with early-onset linked to angle closure and delayed-onset associated with microcornea. Early surgery in microphthalmic eyes increases glaucoma risk.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology

Background:

  • Congenital cataracts are a leading cause of childhood visual impairment.
  • Cataract surgery in children, while sight-saving, can lead to serious postoperative complications.
  • Glaucoma is a significant concern following pediatric cataract extraction.

Purpose of the Study:

  • To identify the etiological factors of glaucoma in children after cataract removal.
  • To analyze the relationship between cataract surgery parameters and subsequent glaucoma development.

Main Methods:

  • Retrospective study of 24 patients (37 eyes) with congenital cataracts who developed glaucoma post-surgery.
  • Evaluation of cataract morphology, surgical techniques, and postoperative complications.
  • Analysis of glaucoma onset timing, gonioscopic findings, microcornea presence, and filtration angle histopathology.

Main Results:

  • A bimodal pattern of glaucoma onset was observed: early (mean 6 months) and delayed (mean 12 years).
  • Early-onset glaucoma was significantly associated with angle closure (P=0.018).
  • Delayed-onset glaucoma showed open filtration angles in 86% of eyes, with microcornea being a significant risk factor (P=0.006).

Conclusions:

  • Early cataract surgery in microphthalmic eyes and retained lens material elevate glaucoma risk.
  • Prophylactic iridectomy is recommended for eyes susceptible to pupillary block.
  • Delayed-onset glaucoma is linked to incomplete filtration structure development, with early surgery and microcornea as key risk factors.
Abstract

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