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The incidence of glaucoma following paediatric cataract surgery: a 20-year retrospective study
A Tatham1, N Odedra, S Tayebjee
1Department of Ophthalmology, University Hospitals Leicester, Infirmary Square, Leicester, UK. andrewtatham@yahoo.co.uk
Insights
Pediatric cataract surgery in children aged 14 or less showed a low incidence of glaucoma. Early surgery, even within the first 6 weeks of life, did not increase glaucoma risk.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Glaucoma Research
Background:
- Congenital and developmental cataracts require surgical intervention in children.
- The risk of secondary glaucoma following pediatric cataract extraction is a significant concern.
- Variability in glaucoma prevalence necessitates further investigation into risk factors.
Purpose of the Study:
- To determine the incidence of glaucoma in children after cataract surgery.
- To assess if early surgical intervention (within the first 50 days of life) increases glaucoma risk.
- To identify potential risk factors for glaucoma beyond surgical timing.
Main Methods:
- Retrospective chart review of pediatric patients (≤14 years) undergoing cataract surgery over 20 years.
- Patients categorized into three age groups at surgery: ≤50 days, 51 days–1 year, and 1–14 years.
- Analysis of glaucoma development with a median follow-up of 4.9 years.
Main Results:
- 100 eyes from 71 children were analyzed; 2% developed glaucoma post-surgery.
- No glaucoma cases were observed in eyes operated on at ≤50 days of age.
- One patient in the 51-day to 1-year group developed bilateral glaucoma 11 years post-surgery.
Conclusions:
- The incidence of glaucoma after pediatric cataract surgery in this series was low.
- Surgery within the first 6 weeks of life was not associated with an increased risk of glaucoma.
- Factors other than age at surgery appear to be crucial in the development of glaucoma.
Aims:
To analyse the incidence of glaucoma in children undergoing cataract surgery and determine whether early surgery is associated with increased risk of glaucoma.
Methods:
A retrospective chart review of all children aged 14 years or less who had surgery for congenital or developmental cataract at one unit over the last 20 years. The children were divided into three groups; group 1 consisting of children aged < or =50 days at surgery, group 2 those aged 51 days to 1 year, and group 3 aged 1-14 years.
Results:
We identified a total of 104 eyes of 74 children. The medical records for 100 eyes (71 children) were available for review. In all, 17 eyes (12 children) were aged < or =50 days at surgery, none of which have developed glaucoma. Group 2 consisted of 28 eyes (17 children) with one patient developing glaucoma in both eyes 11 years after surgery. Group 3 consisted of 55 eyes (42 children), none of which have developed glaucoma. After a median follow-up period of 4.9 years (range 0.6-19.6 years, mean 6.4 +/- 5.2 years) 2% of eyes had developed glaucoma. There was no significant difference in the length of follow-up between groups (H=2.979, P=0.22, Kruskal-Wallis Test).
Conclusions:
There was a low incidence of glaucoma in our series and this was not increased in those having surgery in the first 6 weeks of life. Our findings contribute further evidence for the variability in prevalence of glaucoma after paediatric cataract extraction in the literature and suggest that factors other than age at surgery are important risk factors for this condition.
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