Lens-induced Glaucoma 65 Years After Congenital Cataract Surgery

Barnhorst, Donald A.; Meyers, Sanford M.; Myers, Teresa M.

doi:10.1016/s0002-9394(14)72563-2

Cited by 18 publications

(9 citation statements)

References 1 publication

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“…2,3,5,7,20,[23][24][25] Therefore, buphthalmos, which usually occurs in the first 2 to 3 years of life, is generally not present. The latest time after lensectomy that glaucoma developed in our study was 33 years, compared with the literature's citing of 45 15 to 65 26 years. Because it is also difficult to predict which eyes will develop aphakic glaucoma, 25 lifetime surveillance for glaucoma after congenital cataract surgery is necessary.…”

Section: Resultsmentioning

confidence: 54%

Aphakic Glaucoma After Congenital Cataract Surgery

Chen¹

2004

Arch Ophthalmol

119

132

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To describe the largest series of patients who developed aphakic glaucoma after lensectomy for congenital cataracts. Methods: A retrospective review was performed of all patients seen by a pediatric glaucoma specialist between October 1, 1970, and November 30, 2002. Patients with intraocular pressures greater than 25 mm Hg after lensectomy were studied. Patients with either conditions independently associated with glaucoma or any signs of glaucoma before lensectomy were excluded. Results: We studied 170 eyes of 117 patients. The mean±SD follow-up period was 8.6±7.6 years. The most common cataract types were complete (40.8%) and nuclear (22.5%). For the lensectomies, 103 eyes underwent modern vitrectomy techniques, and 10 underwent older techniques. Lensectomies were performed in 80.6% of eyes before age 1 year. Onset of glaucoma after lensectomy was by 1 year in 37.1% of eyes, by 6 years in 75.9%, and by 33 years in 100%. Of eyes that had gonioscopy, 93.9% had open angles. Glaucoma surgery was needed in 57.1% of eyes. The median final visual acuity was 20/400. Conclusions: Most cases of aphakic glaucoma are of the open-angle type. Various risk factors are suggested, and the prognosis is guarded. Lifelong follow-up is needed to screen for glaucoma.

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Section: Resultsmentioning

confidence: 54%

Aphakic Glaucoma After Congenital Cataract Surgery

Chen¹

2004

Arch Ophthalmol

119

132

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“…Residual lens material does not seem to affect the angle directly, which was seen in two eyes in our study. However, in rare circumstances, lens-induced glaucoma can occur long after pediatric cataract surgery 26 . Therefore, the configurational abnormities, mentioned above, may warrant long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

The long-term anterior segment configuration after pediatric cataract surgery and the association with secondary glaucoma

Chen

Gong

Xie

et al. 2017

Sci Rep

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Secondary glaucoma constitutes major sight-threatening complication of pediatric cataract surgery, yet the etiology remains unclear. The purpose of this study was to investigate the long-term anterior segment configuration and the association with secondary glaucoma in pediatric pseudophakia. Ultrasound biomicroscopy (UBM) was performed on 40 eyes of 26 children underwent pediatric cataract surgery and intraocular lens (IOL) implantation. The anterior chamber depth (ACD), angle-opening distance at 500 μm (AOD500), trabecular-iris angle (TIA), central corneal thickness (CCT), structural abnormities, IOL position, IOP, and incidence of glaucoma were evaluated. High insertion of iris, in which the iris root is attached more anteriorly than normal, was seen in 13 eyes (32.50%). IOL was located in the capsular bag in 19 eyes and in the ciliary sulcus in 21 eyes. Logistic regression analysis identified high insertion of iris (OR 3.40, 95% CI 1.03–11.17, p = 0.03) and IOL implantation in sulcus (OR 1.39, 95% CI 1.07–4.85, p = 0.04) as independent risk factors for glaucoma. The presence of high insertion of iris and IOL implantation in ciliary sulcus may increase the long-term risk of the development of secondary glaucoma after pediatric cataract surgery.

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“…Posterior laser capsulotomy/membranectomy which have been cited as risk factors for post operative glaucoma in infantile eyes was not required in any our patients [28]. The onset of glaucoma following pediatric cataract surgery is often delayed for many years and has been reported as late as 65 years following surgery [29]. On analyzing the differences in the preoperative characteristics and final outcomes between those who were lost to follow-up after 6 years and those who were not, the difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 74%

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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Lens-induced Glaucoma 65 Years After Congenital Cataract Surgery

Cited by 18 publications

References 1 publication

Aphakic Glaucoma After Congenital Cataract Surgery

Aphakic Glaucoma After Congenital Cataract Surgery

The long-term anterior segment configuration after pediatric cataract surgery and the association with secondary glaucoma

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

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