Abstract
Glaucoma remains a frequent serious complication following cataract surgery in children. The optimal approach to management for ‘glaucoma following cataract surgery’ (GFCS), one of the paediatric glaucoma subtypes, is an ongoing debate. This review evaluates the various management options available and aims to propose a clinical management strategy for GFCS cases. A literature search was conducted in four large databases (Cochrane, PubMed, Embase, and Web of Science), from 1995 up to December 2021. Thirty-nine studies—presenting (1) eyes with GFCS; a disease entity as defined by the Childhood Glaucoma Research Network Classification, (2) data on treatment outcomes, and (3) follow-up data of at least 6 months—were included. Included papers report on GFCS treated with angle surgery, trabeculectomy, glaucoma drainage device implantation (GDD), and cyclodestructive procedures. Medical therapy is the first-line treatment in GFCS, possibly to bridge time to surgery. Multiple surgical procedures are often required to adequately control GFCS. Angle surgery (360 degree) may be considered before proceeding to GDD implantation, since this technique offers good results and is less invasive. Literature suggests that GDD implantation gives the best chance for long-term IOP control in childhood GFCS and some studies put this technique forward as a good choice for primary surgery. Cyclodestruction seems to be effective in some cases with uncontrolled IOP. Trabeculectomy should be avoided, especially in children under the age of one year and children that are left aphakic. The authors provide a flowchart to guide the management of individual GFCS cases.
Highlights
Former terms used to describe childhood glaucoma, including ‘developmental’, ‘congenital’, or ‘infantile’, were often not clearly defined [1,2,3]
This review focuses on the subtype known as glaucoma following cataract surgery (GFCS), which accounts for
The decision to proceed to surgery should be a well-argued one, because younger age is frequently associated with reduced surgical outcomes; medical therapy should be considered the initial strategy of choice in GFCS, possibly to bridge the time to surgery
Summary
Former terms used to describe childhood glaucoma, including ‘developmental’, ‘congenital’, or ‘infantile’, were often not clearly defined [1,2,3]. Glaucoma Research Network Classification recently developed a system for the classification of paediatric glaucoma to unify nomenclature (Figure 1) [3]. This review focuses on the subtype known as glaucoma following cataract surgery (GFCS), which accounts for. 18% of childhood glaucoma [4]. Distributed under the terms and conditions of the Creative Commons.
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