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  • Glaucoma After Treatment for Infant Aphakia

    By Jean Shaw
    Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, February 2021

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    In a secondary analysis of data from a randomized clinical trial, Freedman et al. assessed the 10-year cumulative incidence of glaucoma and glaucoma-related adverse events in children who were enrolled in the Infant Aphakia Treatment Study (IATS). They found that the risk of glaucoma-related ad­verse events continues to increase with longer follow-up of these children.

    Of the 114 infants treated in the IATS, 110 had completed a clinical exam at age 10.5 years, with a mean postsurgical follow-up of 10.4 years (range, 9.3-11.5 years).

    By the 10-year mark, glaucoma status was available for 106 children; of these, 25 eyes had developed glau­coma, and 21 eyes were diagnosed as glaucoma suspects.

    According to results of Kaplan-Mei­er analysis, the risk of glaucoma in all study eyes rose from 9% at one year following cataract removal to 17% at the five-year mark and to 22% at 10 years. When glaucoma suspect status was added, the combined risk rose from 12% at one year to 31% at five years and 40% at 10 years after cataract removal.

    As part of this 10-year assessment, the authors also evaluated the retinal nerve fiber layer (RNFL) and optic nerve head (ONH) health of the chil­dren’s eyes.

    They found that eyes with glauco­ma at 10 years had longer axial lengths than did unaffected eyes and those diagnosed as glaucoma suspect. How­ever, the RNFL was relatively preserved in eyes with glaucoma, and their ONH appearance, visual acuity, and IOP were similar to those of glaucoma suspect and unaffected eyes.

    The results of this study indicate that lifelong surveillance is necessary in children who undergo cataract surgery in infancy, the authors said.

    The original article can be found here.