Prevalence of glaucoma after surgery for PHPV and infantile cataracts

The prevalence of glaucoma associated with pediatric aphakia has been reported to range from 0% to 27%. Few studies have included a significant number of patients with persistent hyperplastic primary vitreous (PHPV) cataracts. The purpose of this study was to evaluate the prevalence of glaucoma in young children undergoing surgery for PHPV and infantile cataracts. The charts of all of the patients who underwent lensectomy/vitrectomy for infantile and PHPV cataracts at the University of Iowa Hospitals and Clinics between 1975 and 1992 were reviewed. Patients with ocular abnormalities that might predispose to glaucoma and patients with less than 6 months follow up were excluded. A total of 72 patients (109 eyes) were identified: 25 patients (26 eyes) with PHPV cataracts and 47 patients (83 eyes) with infantile cataracts. Mean age at time of surgery for both groups was 3.5 months. Mean follow up was 84.5 months for those with PHPV, and 76.9 months for those with infantile cataracts. Glaucoma developed in eight (32%) of the 25 patients with PHPV and in 15 (32%) of the 47 with infantile cataracts. Mean time to onset of glaucoma was 64.6 months for those with PHPV and 47.5 months for those with infantile cataracts (P = .70). Although there was no significant difference between the prevalence of postoperative glaucoma in those with infantile and those with PHPV cataracts, the prevalence of glaucoma in these patients is high. Children with aphakia should be closely monitored for glaucoma throughout their lives.