Younger congenital cataract patients may have greater risk of glaucoma

This study found that younger patients undergoing unilateral congenital cataract surgery seem more likely to develop a glaucoma-related adverse event within one year of surgery. The authors recommend vigilance for the early development of glaucoma following congenital cataract surgery, especially when performed during early infancy or in a child with persistent fetal vasculature (PFV).

The authors analyzed the one-year data from the Infant Aphakia Treatment Study. Of the 114 infants included in the analysis, 9 percent developed glaucoma and 4 percent were glaucoma suspect within the first year after surgery. More eyes developed glaucoma after primary IOL implantation (12 percent) than after cataract removal without IOL insertion (5 percent).

Multivariate regression analysis showed that after adjusting for age the odds of developing a glaucoma-related adverse event were 3.1 times higher for patients with PFV and that, after adjustment for PFV, the odds of developing a glaucoma-related adverse event were 1.6 times higher for each month of age younger at cataract surgery.

Eyes that developed a glaucoma-related adverse event had a median visual acuity of three lines worse than those that did not. Although this difference did not reach statistical significance, likely due to the small size of the glaucoma group, the authors expect a statistically significant difference in visual acuity to develop in this group with longer follow-up.