GLAUCOMA FOLLOWING INFANTILE CATARACT SURGERY

 

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).