Elevated intraocular pressure in paediatric cataract surgery in a reference centre
S Mediero1, J Peralta Calvo1, N Pastora Salvador1
1Departamento de Oftalmología, Hospital Universitario La Paz, Madrid, España.
Insights
Elevated postoperative intraocular pressure (PIOP) is common after pediatric cataract surgery, especially in bilateral cases and younger infants. This condition is linked to poorer visual outcomes and occurs more frequently without intraocular lens implantation.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Pediatric cataract surgery presents unique challenges regarding intraocular pressure management.
- Elevated postoperative intraocular pressure (PIOP) is a significant concern following these procedures.
Purpose of the Study:
- To investigate the incidence and characteristics of elevated postoperative intraocular pressure (PIOP) in pediatric cataract surgery.
- To compare findings with existing global literature.
Main Methods:
- Retrospective observational study of 99 patients (142 eyes) undergoing pediatric cataract surgery between 2000 and 2008.
- Data collected from clinical records.
Main Results:
- A PIOP of ≥20mmHg was observed in 20.4% of eyes over a 5-year follow-up.
- Higher PIOP rates were noted in eyes with bilateral cataracts (79.3%) compared to unilateral (20.7%).
- Surgery before one month of age (50%) showed higher PIOP rates than surgery after one month (17.2%).
- PIOP ≥20mmHg was associated with lower best-corrected visual acuity at 5 years (P=.020).
- Eyes without intraocular lenses had higher PIOP rates (69%) than those with lenses (31%).
Conclusions:
- Elevated PIOP is a notable complication of pediatric cataract surgery.
- PIOP elevation is more prevalent in bilateral cataracts and aphakic eyes.
- Early cataract surgery (before one month) is linked to increased PIOP.
Objective:
To study elevated postoperative intraocular pressure (PIOP) after paediatric cataract surgery in a reference centre and to compare the results obtained with the most relevant world literature.
Materials And Methods:
A retrospective observational study was conducted, collecting information from clinical records of 99 patients (142 eyes) operated on due to unilateral or bilateral paediatric cataracts between 2000 and 2008.
Results:
The proportion of eyes with PIOP≥20mmHg and bilateral cataracts was higher, 79.3%, than the proportion of eyes with PIOP≥20mmHg and a unilateral cataract, 20.7% (P=.032). The proportion of eyes with PIOP≥20mmHg between the eyes with cataract surgery before one month of age was higher, 50%, than between the eyes in which the cataract surgery was performed after one month of age, 17.2% (P=.009). PIOP values≥20mmHg were associated with a lower best corrected visual acuity at 5 years after cataract surgery (P=.020). The proportion of eyes with PIOP≥20mmHg and without intraocular lenses was higher, 69%, than the proportion of eyes with PIOP≥20mmHg and intraocular lenses, 31% (P<.001).
Conclusions:
A PIOP>20mmHg was observed in 20.4% of eyes in a 5-year follow-up period, appearing more frequently in eyes with bilateral cataract than unilateral, and in aphakic eyes more than pseudophakic eyes. Elevation of the PIOP was associated with the performance of cataract surgery at early ages.
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