High risk of glaucoma after congenital cataract surgery

This retrospective study estimates that nearly two-thirds of eyes undergoing congenital cataract surgery will develop glaucoma or become glaucoma suspects within 10 years of surgery.

The authors reviewed the charts of 37 children (62 eyes) who underwent congenital cataract surgery when less than seven months of age performed by the same surgeon using a limbal approach. The median age at surgery was two months and the median follow-up was eight years.

All patients were managed by a pediatric glaucoma specialist. The study used the Infant Aphakia Treatment Study definition of glaucoma, which requires the presence of both ocular hypertension and progressive optic disc cupping or buphthalmos.

Nine eyes (14.5 percent) developed glaucoma a median of 4.3 months after cataract surgery and an additional 16 eyes (25.8 percent) were diagnosed as glaucoma suspects a median of eight years after cataract surgery. The probability of any eye developing glaucoma was estimated to be 19.5 percent by 10 years after congenital cataract surgery. When the probability of glaucoma and glaucoma suspect were combined, the risk increased to 63 percent.

The authors conclude that careful monitoring of eyes for glaucoma following early congenital cataract surgery is important because of the high risk. Early diagnosis and treatment of eyes with elevated IOP may delay the onset of glaucoma in these eyes.