Abstract
Purpose
A prospective longitudinal cohort study was performed to assess the incidence of and risk factors for the development of glaucoma following surgery for congenital/infantile cataract.
Methods
One hundred and one eyes of one hundred and one children, ≤12 years of age who had follow-up of ≥24 months were included. Group I included those who underwent surgery using an anterior approach, group II included those who underwent surgery using a posterior approach, and group III included those who underwent surgery using an anterior approach along with foldable intraocular lens implantation. Standard definitions for glaucoma and glaucoma suspect were used. The Cox proportional hazard model was used to analyze risk factors for glaucoma.
Results
Group I: 30 eyes (29.7%); group II: 11 eyes (10.9%); group III 60 eyes (59.4%). The incidence of glaucoma + glaucoma suspect was 7.9% (95% CL: 2.6, 13.2%) in the entire group. The incidence in group I was 16.7% (95% CL 3%, 30%), in group II was 18.2% (95% CL: 0, 41%) and in group III was 1.7% (95% CL: 0, 4.9%). Gonioscopy revealed high iris insertion with grade I (modified Shaffer grading) in one eye each in the glaucoma and glaucoma suspect group and open angles in the rest. Age at surgery of ≤3 months (HR: 6.6, 95% CL: 1.4, 30.6, p = 0.01) was found to be a significant risk factor within the aphakic group.
Conclusions
Younger age at the time of surgery was the only identifiable risk factor for glaucoma.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Simon JW, Mehta N, Simmons SJ, Catalano RA, Linninger CC. Glaucoma after pediatric lensectomy/vitrectomy. Ophthalmology. 1991;98:670–74.
Egbert JE, Wright MM, Dahlhauser KF, Keithahn MAZ, Letson RD. Summers CGl. A prospective study of ocular hypertension and glaucoma after pediatric cataract surgery. Ophthalmology. 1995;102:1098–101.
Tatham A, Odedra N, Anwar S, Woodruff G. The incidence of glaucoma following pediatric cataract surgery: a 20-year retrospective study. Eye. 2010;24:1366–75.
Wong IB, Sukthankar VD, Cortina-Borja, Nischal KK. Incidence of early-onset glaucoma after infant cataract extraction with or without intraocular lens implantation. Br J Ophthalmol. 2009;93:1200–03.
Ruddle RJ, Staffieri SE, Crowston AG, Sherwin JC, Mackey DA. Incidence and predictors of glaucoma following surgery for congenital cataract in the first year of life in Victoria, Australia. Clin Exp Ophthalmol. 2013;41:653–61.
Lambert SR, Purohit A, Superak HM, Lynn MJ, Beck AD. Long-term risk of glaucoma after congenital cataract surgery. Am J Ophthalmol. 2013;156:355–61.
Baden C, Shija F, Lewallen S, Courtright P, Hall A. Glaucoma after pediatric cataract surgery in a population with limited access to care. J AAPOS. 2013;17:158–62.
Wallace DK, Plager DA. Corneal diameter in childhood aphakic glaucoma. J Pediatr Ophthalmol Strabismus. 1996;33:230–34.
Nishina S, Noda E, Azuma N. Outcome of early surgery for bilateral congenital cataracts in eyes with microcornea. Am J Ophthalmol. 2007;144:276–80.
Swamy BN, Billson F, Martin F, Hing S, Smith JEH et al. Secondary glaucoma after pediatric cataract surgery. Br J Ophthalmol. 2007;91:1627–30.
Vishwanath M, Cheong- Leen R, Taylor D, Russel –Eggit R, Rahi J. Is early surgery for congenital cataract a risk factor for glaucoma? Br J Ophthalmol. 2004;88:905–10.
Kuhli-Hattenbach C, Luchtenberg M, Kohnen T, Hattenbach L. Risk factors for complications after congenital cataract surgery without intraocular lens implantation in the first 18 months of life. Am J Ophthalmol. 2008;146:1–7.
Khan AO, Al-Dahmesh S. Age at the time of cataract surgery and relative risk for aphakic glaucoma in nontraumatic infantile cataract. J AAPOS. 2009;13:166–69.
Kothari M, Bhaskare A, Mete D, Toshniwal S, Doshi P, Kaul S. Evaluation of central steady maintained fixation grading for predicting inter-eye visual acuity difference to diagnose and treat amblyopia in strabismic patients. Indian J Ophthalmol. 2009;57:281–84.
Baskaran M, Oen FTS, Chang Y-H, Hoh S-J, Ho C-L, Kashiwagi K, et al. Comparison of the scanning peripheral anterior chamber depth analyzer and the modified van Herick grading system in the assessment of angle closure. Ophthalmology. 2007;114:501–06.
Walton DS. Pediatric aphakic glaucoma: a study of 65 patients. Trans Am Ophthalmol Soc. 1995;93:403–13.
Beck AD, Freedman SF, Lynn MJ, Bothun E, Neely DE, Lambert SR. Glaucoma-related adverse events in the infantile apakia treatment study. 1-Year results. Arch Ophthalmol. 2012;130:300–05.
Freedman SF, Lynn MJ, Beck AD, Bothun ED, Orge FH, Lambert SR. Glaucoma-related adverse events in the first 5 years after unilateral cataract removal in the infantile aphakia treatment study. JAMA. 2015;133:907–14.
Beck A, Chang T, Freedman S. Definition, classification, differential diagnosis. In: Weinreb R, Grajewski A, Papadapoulous M, Grigg J, Freedman S, editors. Childhood glaucoma: The 9th Consensus Report of the World Glaucoma Association. Amsterdam: Kugler Publications; 2013. p. 3–14. .
Chak M, Rahi JS. Incidence of and risk factors associated with glaucoma after surgery for congenital cataract: findings from the British congenital cataract study. Ophthalmology. 2008;115:1013–18.
Mataftsi A, Haidich AB, Kokkali S, Rabiah PK, Birch E, Stager DR, et al. Post operative glaucoma following infantile cataract surgery: an individual patient data meta-analysis. JAMA Ophthalmol. 2014;132:1059–67.
Papadapoulos M, Khaw PT. Meeting the challenge of glaucoma after pediatric cataract surgery. Eye. 2003;17:1–2.
Shah SK, Praveen MR, Vasavada AR, Vasavada VA, Carelli R, Trivedi RH. Long-term longitudinal assessment of post operative outcomes after congenital cataract surgery in children with congenital rubella syndrome. J Cataract Refract Surg. 2014;40:2091–8.
Kruger SJ, Wilson ME Jr, Hutchinson AK, Peterseim MM, Bartholomeo LR, Saunders RA. Cataract and glaucoma in patients with oculo-cerebral renal syndrome. Arch Ophthalmol. 2003;121:1234–7.
Bremer DC, Roberts DC, Good WV, Tung B, Hardy RJ, Fellows R. Glaucoma in the early treatment for retinopathy of prematurity (ETROP) study. J AAPOS. 2012;16:449–52.
Balekudaru S, Sankaranarayanan N, Agarkar S. Prevalence, incidence and risk factors for the development of glaucoma in patients with aniridia. J Paediatr Ophthalmol Strabismus. 2017;54:250–55.
Vasavada VA, Pravenn MR, Tassignon M-J, Shah SK, Vasavada VA, Vasavada VA, et al. Posterior capsule management in congenital cataract surgery. J Cataract Refract Surg. 2011;37:173–93.
Michaelides M, Bunce C, Adams GG. Glaucoma following congenital cataract surgery-the role of early surgery and posterior capsulotomy. BMC Ophthalmol. 2007;11:7–13.
Barnhorst D, Meyers SM, Myers T. Lens induced glaucoma 65 years after congenital cataract surgery. Am J Ophthalmol. 1994;118:807–8.
McNemainin PG. Amorphological study of the inner surface of the anterior chamber angle in pre and post natal human eyes. Curr Eye Res. 1989;8:727–39.
Michael I, Walton DS, Levenberg S. Infantile aphakic glaucoma; a proposed etiological role of IL-4 and VEGF. J Pediatr Ophthalmol Strabismus. 2011;48:98–107.
Nishijima K, Takahashi K, Yamakawa R. Ultrasound biomicroscopy of the anterior segment after congenital cataract surgery. Am J Ophthalmol. 2000;130:483–89.
Francois J. Late results of congenital cataract surgery. Ophthalmology. 1979;86:1586–98.
Chen TC, Walton DS, Bhatia LS. Aphakic glaucoma after congenital cataract surgery. Arch Ophthalmol. 2004;122:1819–25.
Asrani SG, Freedmann S, Hassalblad V, Buckley EG, Egbert J, Dahan E, et al. Does primary intraocular lens implantation prevent ‘aphakic’ glaucoma in children? J AAPOS. 2000;4:33–9.
Morrison DG, Lynn MJ, Freedman SF, Orge FH, Lambert SR. Corneal changes in children after unilateral cataract surgery in the infant aphakia treatment study. Ophthalmology. 2015;122:2186–92.
Fenerty C, Freeman N and Grigg J. Glaucoma following cataract surgery. In: Weinreb RN,Grajenski AL, Papadapoulos M, Grigg J, Freedman S, editors. Childhood glaucoma: the 9th consensus report of the world glaucoma association. p. 233–47, (Kugler publications; Amsterdam, The Netherlands, 2013).
Plager DA, Lynn MJ, Buckley EG, Wilson ME, Lambert SR. Complications in the first 5 years following cataract surgery in infants with and without intraocular lens implantation in the infant aphakia treatment study. Am J Ophthalmol. 2014;158:892–98.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary information
Rights and permissions
About this article
Cite this article
Balekudaru, S., Agarkar, S., Guha, S. et al. Prospective analysis of the predictors of glaucoma following surgery for congenital and infantile cataract. Eye 33, 796–803 (2019). https://doi.org/10.1038/s41433-018-0316-8
Received:
Revised:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41433-018-0316-8
This article is cited by
-
Long-term surgical outcomes of pediatric cataract—multivariate analysis of prognostic factors
Scientific Reports (2023)
-
10-Year Outcomes of Pediatric Cataract Surgery with Foldable Intraocular Lens Implantation and Posterior Continuous Curvilinear Capsulorhexis
Ophthalmology and Therapy (2023)
-
Operationszeitpunkt der kongenitalen Katarakt
Der Ophthalmologe (2020)


