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Paediatric aphakic glaucoma

Caitriona Kirwan1, Michael O'Keefe

  • 1Children's University Hospital, University College Dublin, Dublin, Ireland.

Acta Ophthalmologica Scandinavica
|November 7, 2006
PubMed

Insights

Aphakic glaucoma in children, a complication of congenital cataract surgery, requires lifelong monitoring. Current treatments offer limited success, highlighting the need for improved management strategies for this sight-threatening condition.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery

Background:

  • Aphakic glaucoma is a severe complication following congenital cataract surgery in children.
  • Incidence ranges from 15-45%, particularly in infants operated on before 4 weeks of age.
  • Open-angle glaucoma is the most common form, often presenting diagnostic challenges in pediatric patients.

Purpose of the Study:

  • To review the current understanding and management of aphakic glaucoma in children.
  • To evaluate the efficacy of current treatment modalities.
  • To emphasize the long-term care requirements for affected children.

Main Methods:

  • Review of clinical information regarding aphakic glaucoma.
  • Analysis of treatment outcomes for medical and surgical interventions.
  • Assessment of the role of intraocular lenses and surgical procedures like trabeculectomy and Seton implantation.

Main Results:

  • Intraocular lenses do not appear to protect against glaucoma development; observed lower incidence in pseudophakic eyes is likely due to selection bias.
  • Surgical treatments, including trabeculectomy with mitomycin C and Seton implants, are mainstays, with Seton implants showing better short- and long-term success.
  • Cyclodestructive procedures are used for refractory cases, but overall surgical success rates range from 14-44%, often necessitating additional medical treatment.

Conclusions:

  • Aphakic glaucoma in children is a challenging condition requiring lifelong management.
  • Current treatments have variable success rates, and many children experience poor vision and glaucoma control.
  • Further research and improved management strategies are crucial to prevent vision loss in these patients.
Abstract

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