Cataract surgery, especially infantile
cataract surgery, is associated with a higher incidence of glaucoma
post-operatively.
Choe et al have identified the risk factors
for incisional glaucoma surgery following infantile cataract (IC) surgery.
The population-based cohort study was
conducted using the Korean National Health claims database, among Korean
children born between 2002 and 2018.
650 patients had undergone IC surgery with
a mean (standard deviation [SD]) follow-up period of 6.2 (3.2) years.
92 (14.2%) were diagnosed with glaucoma
following infantile cataract surgery (GFICS).
Among them, 21 patients (22.8%) underwent
incisional glaucoma surgery after a mean (SD) follow-up duration of 5.4 (2.8)
years from the diagnosis of GFICS.
Of the 21 GFICS patients who underwent
incisional glaucoma surgery, the median (IQR) age at incisional glaucoma
surgery was 4 years. Among them, 10 patients underwent trabeculectomy (TLE), 10
underwent glaucoma drainage implant (GDI) surgery, and one underwent both TLE
and GDI surgery.
The risk factors for developing GFICS include
young age at IC surgery, microphthalmia, aphakia, and usage of trypan blue
during surgery.
However, the Infant Aphakia Treatment Study
(IATS) randomized clinical trial (RCT) identified similar risks of GFICS
in both aphakia and pseudophakia groups.
In the multivariable analysis, genetic,
metabolic, infectious comorbidities, and ophthalmic anomalies were not
associated with the risk of undergoing incisional glaucoma surgery.
Likewise, factors associated with IC (i.e.,
age at IC diagnosis, age at IC surgery, type of IC surgery, and location of IC
surgery institution) also were not associated with the risk of incisional
glaucoma surgery.
However, younger age at diagnosis of GFICS was
the only risk factor associated with subsequent incisional glaucoma surgery (P = 0.03).
REFERENCE:
Choe, S., Kim, Y.K. & Ha, A. Nationwide incidence of and
risk factors for undergoing incisional glaucoma surgery following infantile
cataract surgery. Sci Rep 14, 16286 (2024).
