Glaucoma after pediatric cataract surgery in a population with limited access to care

Baden, C.J.; Shija, Fortunate; Lewallen, Susan; Courtright, Paul; Hall, A.

doi:10.1016/j.jaapos.2012.11.009

Cited by 19 publications

(7 citation statements)

References 21 publications

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“…Our incidence of glaucoma and glaucoma suspect was much lower than the incidence quoted in most reports in the literature [1][2][3][4][5][6][7]. There are several explanations for the lower incidence.…”

Section: Discussioncontrasting

confidence: 64%

Prospective analysis of the predictors of glaucoma following surgery for congenital and infantile cataract

Balekudaru

Agarkar

Guha

et al. 2018

Eye

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Purpose A prospective longitudinal cohort study was performed to assess the incidence of and risk factors for the development of glaucoma following surgery for congenital/infantile cataract. Methods One hundred and one eyes of one hundred and one children, ≤12 years of age who had follow-up of ≥24 months were included. Group I included those who underwent surgery using an anterior approach, group II included those who underwent surgery using a posterior approach, and group III included those who underwent surgery using an anterior approach along with foldable intraocular lens implantation. Standard definitions for glaucoma and glaucoma suspect were used. The Cox proportional hazard model was used to analyze risk factors for glaucoma. Results Group I: 30 eyes (29.7%); group II: 11 eyes (10.9%); group III 60 eyes (59.4%). The incidence of glaucoma + glaucoma suspect was 7.9% (95% CL: 2.6, 13.2%) in the entire group. The incidence in group I was 16.7% (95% CL 3%, 30%), in group II was 18.2% (95% CL: 0, 41%) and in group III was 1.7% (95% CL: 0, 4.9%). Gonioscopy revealed high iris insertion with grade I (modified Shaffer grading) in one eye each in the glaucoma and glaucoma suspect group and open angles in the rest. Age at surgery of ≤3 months (HR: 6.6, 95% CL: 1.4, 30.6, p = 0.01) was found to be a significant risk factor within the aphakic group. Conclusions Younger age at the time of surgery was the only identifiable risk factor for glaucoma. Glaucoma remains one of the serious vision-threatening complications following surgery for congenital and infantile cataract with the incidence varying from 2 to 60% [1-7]. Variations in the incidence reflect differences in the study populations, in the definitions of glaucoma used, in the techniques of cataract surgery performed, as well as the duration of follow-up reported. Risk factors reported for the development of glaucoma include younger age at the time of surgery, microcornea, persistent fetal vasculature, aphakia, inflammation, type of cataract, bilateral cataract, number of additional surgeries performed and a longer follow-up period [8-13]. There is, however, a paucity of information on the baseline characteristics of patients which may influence the outcome of surgery with regard to the development of glaucoma, such as central corneal thickness (CCT), preoperative horizontal corneal diameter (HCD, axial length (AXL) and preoperative gonioscopic features. We performed a prospective study on the incidence of and risk factors for the development of glaucoma following surgery for congenital/infantile cataract in children who underwent a detailed preoperative assessment.

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Section: Discussioncontrasting

confidence: 64%

Prospective analysis of the predictors of glaucoma following surgery for congenital and infantile cataract

Balekudaru

Agarkar

Guha

et al. 2018

Eye

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“…The number of pediatric cataract surgeries performed in pediatric ophthalmology centers in Africa continues to increase 23 as public awareness of childhood cataracts increases and access is improved. Our cost-analysis study will facilitate resource allocation to the screening, treatment, and management of childhood cataract by facilitating informed decisions regarding future and existing CEHTFs.…”

Section: Discussionmentioning

confidence: 99%

A cost analysis of pediatric cataract surgery at two child eye health tertiary facilities in Africa

Evans

Lenhart

Lin

et al. 2014

Journal of American Association for Pediatric Ophthalmology and

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Purpose To determine the direct cost of pediatric cataract surgery at two child eye health tertiary facilities (CEHTFs) in Africa. Methods The direct cost of pediatric cataract surgery was determined by reviewing data collected from two CEHTFs in Zambia and Malawi. Inventory, cost, and usage data of all durable medical equipment, consumable equipment, personnel, and medications were collected and the direct cost per child calculated. Results For cataract surgery and related treatment during 2011, the total cost per child was calculated to be $202 for Malawi and $277 for Zambia using figures derived from estimating labor cost allocation proportional to employee time devoted to pediatric cataract management. The onetime equipment cost totaled $178,121 for Malawi and $179,832 for Zambia. Conclusions These cost estimates may serve as a basis for economic decisions aimed at improving access to care, management, and follow-up for children with cataract and provide useful insights for programs dedicated to promoting organizational and financial sustainability for CEHTFs in Africa.

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“…Younger age at surgery and presence of microphthalmia are high-risk factors. [ 92 ] Intraocular pressure may be controlled on medication or may require surgical intervention. VAO is the most common complication after pediatric cataract surgery with or without IOL surgery and may cause visual deprivation amblyopia.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

Pediatric cataract

Khokhar

Pillay

Dhull

et al. 2017

Indian J Ophthalmol

111

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Pediatric cataract is a leading cause of childhood blindness. Untreated cataracts in children lead to tremendous social, economical, and emotional burden to the child, family, and society. Blindness related to pediatric cataract can be treated with early identification and appropriate management. Most cases are diagnosed on routine screening whereas some may be diagnosed after the parents have noticed leukocoria or strabismus. Etiology of pediatric cataract is varied and diagnosis of specific etiology aids in prognostication and effective management. Pediatric cataract surgery has evolved over years, and with improving knowledge of myopic shift and axial length growth, outcomes of these patients have become more predictable. Favorable outcomes depend not only on effective surgery, but also on meticulous postoperative care and visual rehabilitation. Hence, it is the combined effort of parents, surgeons, anesthesiologists, pediatricians, and optometrists that can make all the difference.

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Glaucoma after pediatric cataract surgery in a population with limited access to care

Cited by 19 publications

References 21 publications

Prospective analysis of the predictors of glaucoma following surgery for congenital and infantile cataract

Prospective analysis of the predictors of glaucoma following surgery for congenital and infantile cataract

A cost analysis of pediatric cataract surgery at two child eye health tertiary facilities in Africa

Pediatric cataract

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