The aetiology in paediatric aphakic glaucoma.

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.