Glaucoma after Congenital Cataract Surgery

Purpose: To determine the incidence and risk factors associated with glaucoma following congenital cataract surgery (CCS) in children under age of 15 Methods: This prospective cohort (since 2006) consisted of children less than 15 years of age who underwent cataract surgery with or without intraocular lens (IOL) implantation. The role of the following factors on the development of glaucoma after CCS including age at surgery, gender, laterality of the cataract, IOL implantation, congenital ocular anomalies, intra- and postoperative complications, length of follow-up, central corneal thickness (CCT) as well as the effect of the age of onset, time to development of glaucoma, and response to treatment were evaluated. Results: Overall, 161 eyes of 96 patients were included in this study of which 28 eyes developed glaucoma. Incidence of glaucoma was 17.4%. Mean±SD age at surgery was 9.3±6.9 (range, 1-24) months in glaucomatous and 40.4±41.1 (range, 1 m-13.6 year) months in non-glaucomatous group (p<0.001). All glaucoma patients had the operation under two years of age. In group 1, 9 (60%) and in group 2, 24 (30%) patients were female (p=0.001). In group 1, 17 eyes (60.7%) and in the group 2, 41 eyes (30.8%) were aphakic (p=0.001). Mean time to diagnosis of glaucoma was 111.2 days (range 30-1200 days). Mean follow-up time was 3.1 years (range, 1-6 years). In 22 (78.6%) eyes glaucoma was diagnosed within six months after surgery. Glaucoma was controlled with medications in 23 eyes (82%) and with surgery in five eyes. Conclusion: In this study the incidence of glaucoma after CCS was 17.4% over a follow-up period of six years. Younger age at the time of lensectomy increases the risk of secondary glaucoma. IOL implantation may protect against glaucoma. Female gender was affected more than male.