Abstract
Purpose
To compare intraocular pressure (IOP) control before and during the first year after secondary intraocular lens (IOL) implantation in children.
Methods
This was a retrospective chart review of children who received secondary IOL implantation. We analyzed IOP and antiglaucoma medications before and after implantation. The latest exam with IOP measurement found within the 2–15 month period after IOL implantation was used for the postoperative data. Failure to maintain IOP control was defined as either the addition of antiglaucoma medication(s) or a rise in IOP > 4 mm Hg. Statistical analyses were performed to assess risk factors for failure to control IOP after surgery, namely age at IOL implantation, preoperative glaucoma status, and IOL fixation location.
Results
A total of 100 eyes were included. The mean duration of follow-up was 7.74 months (SD = 3.11). Twenty-three of one hundred eyes failed to maintain IOP control according to our definition. Eyes with a history of having had a traumatic cataract (n = 3) had a more than threefold increased risk of failure (P = 0.015). Although not statistically significant, very young age at initial cataract surgery (<2 months old) had a twofold increased risk of failure compared to an older age (>12 months old) (P = 0.213). No other risk factors were found to have statistical significance.
Conclusion
Secondary IOL implantation carries a modest risk of worsening IOP control in the first year after implantation, for which, a history of ocular trauma or young age at initial cataract surgery seems to present the highest risk.
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
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.
Wood KS, Tadros D, Trivedi RH, Wilson ME. Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, postoperative outcomes. Eye. 2016;30:1182–6.
Trivedi RH, Wilson ME Jr, Golub RL. Incidence and risk factors for glaucoma after pediatric cataract surgery with and without intraocular lens implantation. J Aapos. 2006;10:117–23.
Chak M, Rahi JS, British Congenital Cataract Interest Group. Incidence of and factors associated with glaucoma after surgery for congenital cataract: findings from the British Congenital Cataract Study. Ophthalmology. 2008;115:1013–8.
Freedman SF, Lynn MJ, Beck AD, Bothun ED, Örge FH, Lambert SR, et al. Glaucoma-related adverse events in the first 5 year after unilateral cataract removal in the Infant Aphakia Treatment Study. JAMA Ophthalmol. 2015;133:907–14.
Wallace DK, Plager DA. Corneal diameter in childhood aphakic glaucoma. J Pediatr Ophthalmol Strabismus. 1996;33:230–4.
Asrani S, Freedman S, Hasselblad 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.
Solebo AL, Rahi JS. Glaucoma following cataract surgery in the first 2 years of life: frequency, risk factors and outcomes from IoLunder2. Br J Ophthalmol. 2019. https://doi.org/10.1136/bjophthalmol-2019-314804.
Trivedi RH, Boden JH, Mickler C, Wilson ME. Intraocular pressure elevation during early postoperative period after secondary intraocular lens implantation in children and adolescents. J Cataract Refract Surg. 2012;38:1633–6.
Tadros D, Trivedi RH, Wilson ME. Primary versus secondary IOL implantation following removal of infantile unilateral congenital cataract: outcomes after at least 5 years. J Aapos. 2016;20:25–9.
Wilson ME Jr, Hafez GA, Trivedi RH. Secondary in-the-bag intraocular lens implantation in children who have been aphakic since early infancy. J Aapos. 2011;15:162–6.
Speeg-Schatz C, Flament J, Weissrock M. Congenital cataract extraction with primary aphakia and secondary intraocular lens implantation in the ciliary sulcus. J Cataract Refract Surg. 2005;31:750–6.
Kim DH, Kim JH, Kim SJ, Yu YS. Long-term results of bilateral congenital cataract treated with early cataract surgery, aphakic glasses and secondary IOL implantation. Acta Ophthalmol. 2012;90:231–6.
Nihalani BR, Vanderveen DK. Secondary intraocular lens implantation after pediatric aphakia. J Aapos 2011;15:435–40.
Shenoy BH, Mittal V, Gupta A, Sachdeva V, Kekunnaya R. Complications and visual outcomes after secondary intraocular lens implantation in children. Am J Ophthalmol. 2015;159:720–6.
Crnic T, Weakley DR Jr, Stager D Jr, Felius J. Use of AcrySof acrylic foldable intraocular lens for secondary implantation in children. J Aapos. 2004;8:151–5.
Koch CR, Kara-Junior N, Serra A, Morales M. Long-term results of secondary intraocular lens implantation in children under 30 months of age. Eye. 2018;32:1858–63.
Funding
This publication was supported by the South Carolina Clinical & Translational Research Institute, Medical University of South Carolina’s CTSA, NIH/NCATS Grant Number 1UL1TR001450 (BW). The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or NCATS.
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.
Rights and permissions
About this article
Cite this article
Ness, P.J., Jackson, C.M., Offerle, T.L. et al. Changes in intraocular pressure control in the first year after secondary intraocular lens implantation in children. Eye 35, 2024–2029 (2021). https://doi.org/10.1038/s41433-020-01193-3
Received:
Revised:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41433-020-01193-3
