Peter K Rabiah1. 1. Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. prabiah@enh.org
Abstract
PURPOSE: To determine the frequency of and identify predictors of chronic glaucoma after pediatric cataract surgery. DESIGN: Interventional case series. METHODS: Retrospective review at an eye hospital identified 570 eyes among 322 patients who underwent limbal-approach surgery without intraocular lens implantation at age <or=16 years for cataract unassociated with other ocular anomalies aside from microcornea. Patients had a minimum of 5 years' postoperative follow-up, which included intraocular pressure measurement. The outcome measure was the presence or absence of postcataract surgery glaucoma, defined as intraocular pressure >or=26 mm Hg, as measured on at least two occasions. RESULTS: Mean follow-up was 9.0 +/- 3.1 years (median, 8.1 years; range, 5.0-18.3 years). Glaucoma developed in 118 of 570 patients' eyes (21%), including 101 of 272 (37%) undergoing surgery at <or=9 months of age and 17 of 298 (6%) undergoing surgery thereafter. Multivariable Cox proportional hazards regression analysis with adjustment for potential intrasubject correlation identified surgery at <or=9 months of age (hazard ratio [HR], 3.8; 95% confidence interval [CI], 1.8-7.7; P <.001), secondary membrane surgery (HR, 2.6; 95% CI, 1.3-5.3; P =.006), microcornea (HR, 1.9; 95% CI, 1.2-3.1; P =.008), and primary posterior capsulotomy/anterior vitrectomy (HR, 10.7; 95% CI, 1.4-80.6; P =.02) as predictors of glaucoma. CONCLUSIONS: Chronic glaucoma is common after cataract surgery performed at or before, but not after, a certain age in childhood. The data suggest that this age threshold is 9 months, but a true threshold occurring at a somewhat later age cannot be fully excluded.
PURPOSE: To determine the frequency of and identify predictors of chronic glaucoma after pediatric cataract surgery. DESIGN: Interventional case series. METHODS: Retrospective review at an eye hospital identified 570 eyes among 322 patients who underwent limbal-approach surgery without intraocular lens implantation at age <or=16 years for cataract unassociated with other ocular anomalies aside from microcornea. Patients had a minimum of 5 years' postoperative follow-up, which included intraocular pressure measurement. The outcome measure was the presence or absence of postcataract surgery glaucoma, defined as intraocular pressure >or=26 mm Hg, as measured on at least two occasions. RESULTS: Mean follow-up was 9.0 +/- 3.1 years (median, 8.1 years; range, 5.0-18.3 years). Glaucoma developed in 118 of 570 patients' eyes (21%), including 101 of 272 (37%) undergoing surgery at <or=9 months of age and 17 of 298 (6%) undergoing surgery thereafter. Multivariable Cox proportional hazards regression analysis with adjustment for potential intrasubject correlation identified surgery at <or=9 months of age (hazard ratio [HR], 3.8; 95% confidence interval [CI], 1.8-7.7; P <.001), secondary membrane surgery (HR, 2.6; 95% CI, 1.3-5.3; P =.006), microcornea (HR, 1.9; 95% CI, 1.2-3.1; P =.008), and primary posterior capsulotomy/anterior vitrectomy (HR, 10.7; 95% CI, 1.4-80.6; P =.02) as predictors of glaucoma. CONCLUSIONS:Chronic glaucoma is common after cataract surgery performed at or before, but not after, a certain age in childhood. The data suggest that this age threshold is 9 months, but a true threshold occurring at a somewhat later age cannot be fully excluded.
Authors: Scott R Lambert; Edward G Buckley; Carolyn Drews-Botsch; Lindreth DuBois; E Eugenie Hartmann; Michael J Lynn; David A Plager; M Edward Wilson Journal: Arch Ophthalmol Date: 2010-05-10
Authors: B N Swamy; F Billson; F Martin; C Donaldson; S Hing; R Jamieson; J Grigg; J E H Smith Journal: Br J Ophthalmol Date: 2007-05-02 Impact factor: 4.638