The incidence of glaucoma following paediatric cataract surgery

Abstract

Abstract Purpose Aphakic glaucoma is a well‐recognised complication of surgery for congenital cataract, however there are wide variations in its reported prevalence. In this study, we investigated the incidence of glaucoma and the visual outcome following surgery in paediatric cataracts. Methods A 10‐year retrospective case‐note review of children who had cataract surgery by the same surgeon for congenital or secondary cataract. The diagnosis of glaucoma was based on the clinician’s decision to initiate treatment for raised intraocular pressure. Results Sixty‐six eyes of 49 patients were identified, comprising; 57.1% (28/49,40 eyes) with congenital cataract, 26.5% (13/49,18 eyes) with cataract secondary to uveitis, and 10.2% (5/49) with traumatic cataract. 12.1% (8/66) of eyes had an intraocular lens inserted at the time of surgery. Of those with congenital cataract, surgery was performed at a median age of 101 days (range 5‐5089). 7.5% (3/40) of these eyes developed glaucoma. The mean interval from surgery to the diagnosis of glaucoma was 3519 days.The age of the patient at surgery was not found to be a significant risk factor for glaucoma (student‐t test, p=0.18). There was a mean follow‐up of 2108 days with no significant difference in the length of follow‐up between the groups. Of the patients with uveitis, 53.8% (7/13) developed glaucoma in the operated eye, with two eventually requiring aqueous shunt devices. Conclusion We found a lower prevalence of glaucoma following surgery for congenital cataract than previously reported. However, glaucoma is significantly more likely following surgery for secondary cataract, particularly that associated with uveitis.