Glaucoma following congenital cataract surgery – the role of early surgery and posterior capsulotomy

Michaelides, Michel; Bunce, Catey; Adams, Gillian

doi:10.1186/1471-2415-7-13

Cited by 54 publications

(53 citation statements)

References 21 publications

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“…Lately, there has been concern that surgery during the first month of life confers a particularly high risk of aphakic glaucoma. 7,14,22,29 Vishwanath et al, 21 found that lensectomy for bilateral infantile cataract during the first month was associated with an increased risk of aphakic glaucoma compared with delayed surgery. The 5-year risk of glaucoma in at least one eye after bilateral lensectomy was 50% with surgery in the first month of life but when surgery was delayed to later in the first year the risk of glaucoma was only 14.9%.…”

Section: Discussionmentioning

confidence: 99%

The incidence of glaucoma following paediatric cataract surgery: a 20-year retrospective study

Tatham

Odedra

Tayebjee

et al. 2010

Eye

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Aims To analyse the incidence of glaucoma in children undergoing cataract surgery and determine whether early surgery is associated with increased risk of glaucoma. Methods A retrospective chart review of all children aged 14 years or less who had surgery for congenital or developmental cataract at one unit over the last 20 years. The children were divided into three groups; group 1 consisting of children aged p50 days at surgery, group 2 those aged 51 days to 1 year, and group 3 aged 1-14 years. Results We identified a total of 104 eyes of 74 children. The medical records for 100 eyes (71 children) were available for review. In all, 17 eyes (12 children) were aged p50 days at surgery, none of which have developed glaucoma. Group 2 consisted of 28 eyes (17 children) with one patient developing glaucoma in both eyes 11 years after surgery. Group 3 consisted of 55 eyes (42 children), none of which have developed glaucoma. After a median follow-up period of 4.9 years (range 0.6-19.6 years, mean 6.4 ± 5.2 years) 2% of eyes had developed glaucoma. There was no significant difference in the length of follow-up between groups (H ¼ 2.979, P ¼ 0.22, Kruskal-Wallis Test). Conclusions There was a low incidence of glaucoma in our series and this was not increased in those having surgery in the first 6 weeks of life. Our findings contribute further evidence for the variability in prevalence of glaucoma after paediatric cataract extraction in the literature and suggest that factors other than age at surgery are important risk factors for this condition.

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Section: Discussionmentioning

confidence: 99%

The incidence of glaucoma following paediatric cataract surgery: a 20-year retrospective study

Tatham

Odedra

Tayebjee

et al. 2010

Eye

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13] Oranlar arasındaki bu farklılık çalışmaya dahil edilen hasta gruplarının yaş ve takip sürelerinin farklı olmasına, tanı kriterlerine, katarakt dışı oküler ve sistemik anomalili hastaların çalışmaya dahil edilip edilmemesine ve cerrahi teknik farklılıklarına bağlı olabilmektedir. Ayrıca hastaların genellikle asemptomatik oluşu, göz içi basıncının ölçümü ve diğer muayenelerdeki zorluklar tanı koymayı güçleştirmektedir.…”

Section: Discussionunclassified

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] Konjenital kataraktlı olguların sadece ameliyat edilmiş gözlerinde ortaya çıkması, 2,14 glokom gelişimi için cerrahinin şart olduğunu göstermektedir. Cerrahinin trabeküler ağ üzerine etkilerini açıklamaya yönelik çeşitli teoriler 12,15 bulunmakla birlikte patogenez tam olarak bilinmemektedir. 1,2 Literatürde risk faktörlerini araştıran çok sayıda çalışma bulunmaktadır.…”

Section: Gi Riflunclassified

“…1,2 Literatürde risk faktörlerini araştıran çok sayıda çalışma bulunmaktadır. [1][2][3][4][5][6][10][11][12][13] Çalışmaların ortak noktası erken cerrahinin en önemli risk faktörü olduğu yönündedir. [1][2][3][4][5][6][10][11][12][13] Diğer risk faktörleri olarak ise mikrokornea, 2,3,13,16 mikroftalmi, 17 kataraktın tipi (nükleer katarakt), 6,13,16 persistan hiperplastik primer vitreus (PHPV), 2 ailede glokom öyküsü, 2,6 primer arka kapsülotomi ve ön vitrektomi, 2,3,12 postoperatif üveit ve membran cerrahisi 3 bildirilmektedir.…”

Section: Gi Riflunclassified

“…Michaelides ve ark. 12 nın çalışmasında da intakt arka kapsülün henüz gelişmekte olan açı yapılarını vitreusun potansiyel zararlı etkilerinden koruduğu ve glokom insidansını azaltıcı etkisi olabileceği belirtilmektedir. Bizim çalışmamızda olduğu gibi diğer çalışmalarda da erken cerrahiye giden olguların çoğunda arka kapsülotomi ve ön vitrekromi yapılmakta, primer olarak yapılmamış olgularda da kısa süre içinde gelişen arka kapsül opasifikasyonu nedeniyle sekonder vitrektomi uygulanmaktadır.…”

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Konjenital Katarakt Cerrahisi Sonrası Sekonder Glokom ve Risk Faktörleri

Solmaz¹,

Önder²,

Koca³

2011

tjo

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Girifl: Konjenital katarakt nedeniyle opere edilen hastalarımızda, glokom insidansını ve risk faktörlerini belirlemek. Yöntem ve Gereç: Ocak 2001-Aralık 2009 tarihleri arasında kliniğimizde ameliyat edilen konjenital kataraktlı olguların verileri retrospektif olarak değerlendirildi. Glokom gelişiminde potansiyel risk faktörleri olarak; primer cerrahi sırasındaki yaş, mikrokornea, eşlik eden sistemik patoloji varlığı ve afaki/psödofaki parametreleri analiz edildi. En az 6 aylık postoperatif takibi bulunan 37 olgunun 65 gözü çalışma kapsamına alındı. Sonuçlar: Olguların primer cerrahi sırasındaki yaş ortalaması 35,6±43,9 (2 ay-17 yıl) aydı. Ortalama 38,6±28,1 (6 ay-8,5 yıl) aylık takip sürecinde 8 olgunun 14 gözünde (%21,5) sekonder glokom geliştiği gözlendi. Cerrahi ile glokom tanısı arasındaki interval 20 ay ile 7 yıl arasında değişmekteydi (47,3±23,3 ay). Afakik ve psödofakik gözler arasında glokom insidansı yönünden fark yoktu. Cerrahi yaşı (p<0,001), mikrokornea (p=0,001) ve sistemik patoloji varlığının(p=0,07) ise glokom gelişimi ile güçlü bir ilişkisi olduğu saptandı. Glokomlu olguların primer cerrahi yaşı ortalama 7.4 ay olup glokom gelişmeyen gruptan (43,4 ay) anlamlı derecede daha düşük, takip süresi ise daha uzundu (p=0,003). Mikrokornealı gözlerde %60, sistemik patolojili olgularda ise %38,5 glokom görülürken, bu oranlar kornea çapı normal olan gözlerde %14,5 ve sistemik sorunu olmayanlarda %10,3'e düşmekteydi. Tart›flma: Erken yaşta cerrahi, mikrokornea ve sistemik patolojilerin varlığı önemli risk faktörleri olup; takip süresi uzadıkça glokom insidansı artmaktadır. Glokomatöz hasara bağlı görme kaybını engellemek için bu hastalar yaşam boyu takip edilmelidir. ( Sum maryPur po se: To determine the risk factors and incidence of glaucoma following congenital cataract surgery in our case series. Patients and Methods: Records of children who underwent cataract surgery between January 2001 and December 2009 were reviewed retrospectively. Age at primary surgery, microcornea, aphakia/ pseudophakia and associated systemic pathology were analyzed as potential risk factors for glaucoma secondary to surgery. Sixty-five eyes of 37 patients having a minimum 6-month follow-up were included in the study. Results: Age at surgery was 35.6±43.9 months (2 months-17 years) with a follow-up period of 38.6±28.1 months (6 months-8.5 years). Glaucoma developed in 8 patients (14 eyes; 21.5%). Time between surgery and glaucoma diagnosis was 47.3±23.3 months (20 months-7 years). Glaucoma incidence in aphakic and pseudophakic cases did not differ. Glaucoma development significantly correlated with age at surgery (p<0.001), microcornea (p=0.001) and presence of systemic pathology (p=0.007). Mean age at surgery was significantly lower in patients with glaucoma diagnosis (7.4 months) than in those who did not develop glaucoma (43.4 months). However, the mean follow-up period was significantly longer in patients with glaucoma (p=0.003). Whereas glaucoma developed in 60% and 38.5% of the eyes of patients with microcornea and systemi...

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Postoperative Glaucoma Following Infantile Cataract Surgery

et al. 2014

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IMPORTANCE Infantile cataract surgery bears a significant risk for postoperative glaucoma, and no consensus exists on factors that may reduce this risk.OBJECTIVE To assess the effect of primary intraocular lens implantation and timing of surgery on the incidence of postoperative glaucoma.DATA SOURCES We searched multiple databases to July 14, 2013, to identify studies with eligible patients, including PubMed, MEDLINE, EMBASE, ISI Web of Science, Scopus, Central, Google Scholar, Intute, and Tripdata. We also searched abstracts of ophthalmology society meetings.STUDY SELECTION We included studies reporting on postoperative glaucoma in infants undergoing cataract surgery with regular follow-up for at least 1 year. Infants with concurrent ocular anomalies were excluded. DATA EXTRACTION AND SYNTHESISAuthors of eligible studies were invited to contribute individual patient data on infants who met the inclusion criteria. We also performed an aggregate data meta-analysis of published studies that did not contribute to the individual patient data. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURESTime to glaucoma with the effect of primary implantation, additional postoperative intraocular procedures, and age at surgery. RESULTSSeven centers contributed individual patient data on 470 infants with a median age at surgery of 3.0 months and median follow-up of 6.0 years. Eighty patients (17.0%) developed glaucoma at a median follow-up of 4.3 years. Only 2 of these patients had a pseudophakic eye. The risk for postoperative glaucoma appeared to be lower after primary implantation (hazard ratio [HR], 0.10 [95% CI, 0.01-0.70]; P = .02; I 2 = 34%), higher after surgery at 4 weeks or younger (HR, 2.10 [95% CI, 1.14-3.84]; P = .02; I 2 = 0%), and higher after additional procedures (HR, 2.52 [95% CI, 1.11-5.72]; P = .03; I 2 = 32%). In multivariable analysis, additional procedures independently increased the risk for glaucoma (HR, 2.25 [95% CI,; P = .01), and primary implantation independently reduced it (HR, 0.10 [95% CI, 0.01-0.76]; P = .03). Results were similar in the aggregate data meta-analysis that included data from 10 published articles. CONCLUSIONS AND RELEVANCEAlthough confounding factors such as size of the eye and surgeon experience are not accounted for in this meta-analysis, the risk for postoperative glaucoma after infantile cataract surgery appears to be influenced by the timing of surgery, primary implantation, and additional intraocular surgery.

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Glaucoma following congenital cataract surgery – the role of early surgery and posterior capsulotomy

Abstract: Background: To determine the rate of glaucoma following congenital cataract surgery at Moorfields Eye Hospital (MEH), and to investigate potential risk factors for glaucoma in our case series.

Cited by 54 publications

References 21 publications

The incidence of glaucoma following paediatric cataract surgery: a 20-year retrospective study

The incidence of glaucoma following paediatric cataract surgery: a 20-year retrospective study

Konjenital Katarakt Cerrahisi Sonrası Sekonder Glokom ve Risk Faktörleri

Postoperative Glaucoma Following Infantile Cataract Surgery

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