Changes in intraocular pressure control in the first year after secondary intraocular lens implantation in children
Peter J Ness1, Colette M Jackson1, Thomas L Offerle1
1Storm Eye Institute, Medical University of South Carolina, Charleston, SC, USA.
Insights
Secondary intraocular lens (IOL) implantation in children may worsen intraocular pressure (IOP) control. Ocular trauma history and very young age at initial cataract surgery increase the risk of IOP elevation post-implantation.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Glaucoma Management
Background:
- Secondary intraocular lens (IOL) implantation is a common procedure in pediatric cases.
- Maintaining optimal intraocular pressure (IOP) is crucial for visual health, especially in children.
Purpose of the Study:
- To evaluate the impact of secondary IOL implantation on IOP control in children within the first year post-surgery.
- To identify risk factors associated with failure to maintain IOP control after secondary IOL implantation.
Main Methods:
- Retrospective chart review of pediatric patients undergoing secondary IOL implantation.
- Analysis of IOP and antiglaucoma medication use before and after surgery.
- Definition of IOP control failure as medication increase or IOP rise >4 mm Hg.
Main Results:
- Twenty-three percent of eyes (23/100) experienced a failure in IOP control.
- A history of traumatic cataract significantly increased the risk of IOP control failure (P=0.015).
- Younger age at initial cataract surgery (<2 months) showed a trend towards increased failure risk, though not statistically significant (P=0.213).
Conclusions:
- Secondary IOL implantation presents a moderate risk of compromised IOP control in the first year.
- Ocular trauma history and very young age at initial cataract surgery are key risk factors for post-implantation IOP elevation.
Purpose:
To compare intraocular pressure (IOP) control before and during the first year after secondary intraocular lens (IOL) implantation in children.
Methods:
This was a retrospective chart review of children who received secondary IOL implantation. We analyzed IOP and antiglaucoma medications before and after implantation. The latest exam with IOP measurement found within the 2-15 month period after IOL implantation was used for the postoperative data. Failure to maintain IOP control was defined as either the addition of antiglaucoma medication(s) or a rise in IOP > 4 mm Hg. Statistical analyses were performed to assess risk factors for failure to control IOP after surgery, namely age at IOL implantation, preoperative glaucoma status, and IOL fixation location.
Results:
A total of 100 eyes were included. The mean duration of follow-up was 7.74 months (SD = 3.11). Twenty-three of one hundred eyes failed to maintain IOP control according to our definition. Eyes with a history of having had a traumatic cataract (n = 3) had a more than threefold increased risk of failure (P = 0.015). Although not statistically significant, very young age at initial cataract surgery (<2 months old) had a twofold increased risk of failure compared to an older age (>12 months old) (P = 0.213). No other risk factors were found to have statistical significance.
Conclusion:
Secondary IOL implantation carries a modest risk of worsening IOP control in the first year after implantation, for which, a history of ocular trauma or young age at initial cataract surgery seems to present the highest risk.
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