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Secondary Glaucoma after Cataract Surgery Performed in Infancy in Congenital Rubella Syndrome: A Case Control Study

Gayathri J Panicker1, Sumita Agarkar1, Mona Khurana2

  • 1Pediatric Ophthalmology and Strabismus Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India.

Ophthalmology. Glaucoma
|July 14, 2024
PubMed

Insights

Children with congenital rubella syndrome (CRS) undergoing cataract surgery have a similar incidence of secondary glaucoma compared to other infantile cataracts. However, long-term glaucoma-free survival is lower in CRS patients, necessitating closer monitoring.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Genetics and Congenital Disorders

Background:

  • Congenital rubella syndrome (CRS) can lead to infantile cataracts, requiring surgical intervention.
  • Secondary glaucoma is a potential complication following cataract surgery in infancy.
  • Risk factors and comparative incidence of secondary glaucoma in CRS patients are not fully elucidated.

Purpose of the Study:

  • To compare the incidence of secondary glaucoma after infantile cataract surgery in children with CRS versus non-rubella cataracts.
  • To identify risk factors associated with the development of secondary glaucoma in these pediatric populations.

Main Methods:

  • Retrospective case-control study design.
  • Inclusion of infants undergoing cataract surgery, comparing CRS cases with age-matched non-rubella cataract controls.
  • Comparison of glaucoma incidence and survival probability, with a minimum 1-year follow-up.

Main Results:

  • No significant difference in the mean age at surgery between CRS and control groups.
  • Cumulative incidence of secondary glaucoma over 14 years was 32.7% in CRS and 24.5% in controls (P=0.19).
  • Significantly lower 10-year glaucoma-free survival in the CRS group (0.53 vs. 0.8; P=0.034). Microcoria was a risk factor in CRS eyes (HR 2.83, P=0.002).

Conclusions:

  • The incidence of secondary glaucoma post-infantile cataract surgery is similar between CRS and non-rubella groups.
  • Children with CRS exhibit a significantly lower probability of remaining glaucoma-free 10 years after surgery.
  • Extended and vigilant follow-up is recommended for all infants undergoing cataract surgery, particularly those with CRS and at-risk features like microcoria.
Abstract

Keywords:
Cataract surgeryChildhood glaucomaCongenital rubella syndromeSecondary glaucoma

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