Risk factors for the development of aphakic glaucoma after congenital cataract surgery

It is well-known that lensectomy surgery during the first year of life increases one's risk of aphakic glaucoma. However, it is controversial whether there is a specific time period during the first year of life after which performing lensectomy surgery has a lower risk of aphakic glaucoma development.

A retrospective chart review was performed of all patients seen by a pediatric glaucoma specialist from 1970 to 2003. Patients were included in the study if they underwent congenital cataract surgery. Cataracts were defined as congenital if they were identified within the first 6 months of life, were dominantly inherited, or were of the lamellar type. Aphakic glaucoma was defined as having repeated intraocular pressures > 25 mm Hg after congenital cataract surgery. Patients were excluded if they had any conditions that were independently associated with glaucoma.

A total of 368 eyes of 258 patients were included in the study. Of these, 216 (58.7%) eyes of 150 patients developed aphakic glaucoma. Risk factors of greatest significance (P < .0001) included having lensectomy within the first year of life and the development of postoperative complications.

No specific age for lensectomy during the first year of life was associated with a decreased risk for development of aphakic glaucoma. Surgery for congenital cataracts should not be delayed if the only reason for delay is to prevent the development of aphakic glaucoma.