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Intraoperative challenges and outcomes of pediatric cataract surgery following glaucoma filtering surgery

Akshay Badakere1, Swathi Vallabh Badakere1, Syed Khaleeluddin Aijaz2

  • 1Swathi Vallabh Badakere- Smt. Jadhavabai Nathmal Singhvee Glaucoma services, Medical Research Foundation, Sankara Nethralaya, Chennai, India.

International Ophthalmology
|June 1, 2024
PubMed

Insights

Pediatric cataract surgery after glaucoma procedures presents challenges like difficult capsulorrhexis and IOL stability. However, visual outcomes and intraocular pressure (IOP) control were generally favorable.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Glaucoma Management

Background:

  • Pediatric cataract surgery following glaucoma filtering surgery requires careful consideration of unique intraoperative challenges.
  • Prior glaucoma surgery can impact the surgical environment for subsequent cataract extraction.

Purpose of the Study:

  • To analyze the intraoperative challenges and outcomes of pediatric cataract surgery in eyes that have previously undergone glaucoma filtering surgery.
  • Evaluate the safety and efficacy of cataract surgery in this specific pediatric population.

Main Methods:

  • Retrospective analysis of pediatric cataract surgeries performed between January 2007 and December 2019 in eyes with prior glaucoma surgery.
  • Data collected included type of glaucoma surgery, cataract surgery technique, intraoperative complications, and postoperative visual acuity and intraocular pressure (IOP).

Main Results:

  • Twenty eyes of 16 children were analyzed; most had prior trabeculectomy or trabeculotomy.
  • The primary intraoperative challenges were difficulty with capsulorrhexis and posterior capsulotomy extension.
  • Postoperative visual acuity showed improvement in some eyes, while intraocular pressure (IOP) remained stable and controlled with or without anti-glaucoma medications. Two eyes developed retinal detachment.

Conclusions:

  • Cataract surgery in pediatric eyes with a history of glaucoma surgery presents specific challenges, particularly with capsulorrhexis and intraocular lens (IOL) stability.
  • Reasonably good visual outcomes and effective IOP control can be achieved in these complex cases.
Abstract

Keywords:
Cataract surgeryGlaucoma filtering surgeryIntraoperativePediatric glaucoma

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