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Pediatric aphakic glaucoma: a study of 65 patients
1Harvard Medical School, Department of Ophthalmology, Boston, Massachusetts, USA.
Transactions of the American Ophthalmological Society
|January 1, 1995
Summary
Pediatric glaucoma after cataract surgery can cause an acquired filtration angle deformity. This complication, often seen years post-surgery, involves iris repositioning and trabecular meshwork blockage.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Glaucoma Research
Background:
- Pediatric cataract extraction is a common procedure.
- Glaucoma is a potential complication following pediatric cataract surgery.
- Understanding the mechanisms of secondary glaucoma is crucial for management.
Purpose of the Study:
- To investigate the anterior segment findings in children who developed glaucoma after pediatric cataract extraction.
- To determine the underlying mechanism of this specific complication.
Main Methods:
- Retrospective study of clinical records of 65 children with glaucoma post-pediatric cataract surgery.
- Analysis of surgical techniques, timing, and patient outcomes.
- Preoperative and postoperative gonioscopy assessments.
Main Results:
- Vitreous cutting instruments were used in 80% of lensectomy procedures, with 77% performed in the first year of life.
- Glaucoma was diagnosed two or more years after lensectomy in 87% of patients.
- Postoperative gonioscopy revealed a consistent angle defect (96%) with iris repositioning against the trabecular meshwork, abnormal pigmentation, and synechia formation.
Conclusions:
- A characteristic acquired filtration angle deformity develops in children with glaucoma after early lensectomy.
- This deformity is associated with residual lens tissue and not chronic anterior segment inflammation.
- The findings highlight a specific mechanism for secondary glaucoma in this pediatric population.