Pseudophakic Pupillary-Block Glaucoma in Children

Vajpayee, Rasik B; Angra, SK; Titiyal, JS; Sharma, Yog Raj; Chabbra, V.K.

doi:10.1016/s0002-9394(14)76777-7

Cited by 27 publications

(7 citation statements)

References 16 publications

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“…We found that sulcus-fixation of the IOL is a risk factor for the development of pupillary block, which has already been observed 7,22,23. In 3 of the 6 eyes in which the IOL was fixed in the sulcus, pseudophakic pupillary block developed.…”

Section: Discussionsupporting

confidence: 53%

Comparison of Delayed-Onset Glaucoma and Early-Onset Glaucoma after Infantile Cataract Surgery

Kang

Yim²,

Biglan³

2006

Korean J Ophthalmol

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PurposeTo investigate the causes and characteristics of glaucoma in children following cataract surgery.MethodsTwenty-four patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma after cataract surgery were studied retrospectively. Variables included cataract morphology, surgical techniques, post-operative complications, time to the onset of glaucoma, gonioscopic findings, presence of microcornea and the histopathologic characteristics of the filtration angle (in one case).ResultsThere was a bimodal onset of glaucoma after cataract surgery. Early-onset glaucoma occurred at a mean age of 6 months in 15 eyes and delayed-onset glaucoma at a mean age of 12 years in 22 eyes. Early-onset glaucoma was significantly (p=0.018) more likely to be due to angle closure than delayed-onset glaucoma. With delayed-onset glaucoma, the filtration angle was open in 86% of eyes and significantly (p=0.006) more eyes in the delayed-onset group had microcornea. Medical treatment was sufficient to control intraocular pressure in the delayed-onset group while the early-onset group required surgical treatment (P<0.001).ConclusionsThe onset of glaucoma after cataract surgery during infancy follows a bimodal pattern that is correlated with the configuration of the filtration angle. The early-onset glaucoma group had high incidence of angle closure requiring surgical treatment, while in the delayed-onset group non-surgical treatment was sufficient to control intraocular pressure. Prophylactic iridectomy in eyes at risk for pupillary block is recommended. Eyes with delayed-onset glaucoma have open filtration angles yet also have findings of incomplete development of filtration structures. Microcornea is a risk factor for delayed-onset glaucoma.

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Section: Discussionsupporting

confidence: 53%

Comparison of Delayed-Onset Glaucoma and Early-Onset Glaucoma after Infantile Cataract Surgery

Kang

Yim²,

Biglan³

2006

Korean J Ophthalmol

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“…Among older children results have been more encouraging9 10 but inflammatory pupil block glaucoma following posterior chamber IOL implantation was common in a series where no peripheral iridectomy had been performed 11. In a study of 67 eyes from children with IOLs following surgery for non-traumatic childhood cataract from the West Bank and Gaza with a follow up of 12–38 months no serious lens induced complications were reported 12…”

Section: Discussionmentioning

confidence: 99%

Use of intraocular lenses in children with traumatic cataract in south India

Eckstein

Vijayalakshmi

Killedar

et al. 1998

British Journal of Ophthalmology

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Aims-To assess the long term results of intraocular lens (IOL) implantation for traumatic cataract in young children in a developing country. Methods-Prospective hospital based study of 52 children (age 2-10 years) undergoing unilateral cataract extraction and IOL insertion for traumatic cataract performed by a single surgeon in south India. Children were reviewed regularly and followed up initially for 3 years. Results-There were no serious operative complications. Clinically significant posterior capsule opacification was almost universal (92%) and YAG capsulotomy or membranectomy was performed on 48 eyes. Some degree of pupil capture affected 35% of eyes and was complete in 6%. Visual acuity was 6/12 or better in 67% of eyes at the last follow up examination. Conclusion-The visual acuity results 3 years after implantation of posterior chamber IOLs in older children with traumatic cataracts in south India were encouraging. In developing countries where follow up is unreliable it is essential to plan to clear the axial part of the posterior capsule either at the time of surgery or soon afterwards. (Br J Ophthalmol 1998;82:911-915) The use of intraocular lenses (IOLs) in infants and young children remains a controversial subject but there have now been many reports from the developed world which show good visual results following posterior chamber lens implantation in children older than 1 year.In developing countries contact lenses are not an option for correction of aphakia following unilateral cataract extraction and IOLs oVer the only realistic solution to early and good visual rehabilitation. In many developing countries aVordable high quality IOLs are now readily available.

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“…Others have also made this observation. 7,[22][23] In three of the six eyes in which the IOL was fixed in the sulcus, pseudophakic pupillary block developed. We recommend placement of the IOL within the capsular bag whenever possible.…”

Section: Mori Et Almentioning

confidence: 99%

The aetiology in paediatric aphakic glaucoma

Koç¹,

Kargı

Biglan

et al. 2005

Eye

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Purpose To investigate the causes of glaucoma in children following removal of cataracts. Methods In total, 24 patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma following cataract removal were studied retrospectively. Cataract morphology, surgical technique, postoperative complications, time to glaucoma onset, gonioscopic findings, the presence of microcornea, and the histopathologic characteristics of the filtration angle in one case were the studied parameters. Results We found a bimodal onset of glaucoma. Early-onset glaucoma occurred at a mean age of 6 months in 15 eyes and delayedonset glaucoma at a mean age of 12 years in 22 eyes. Early-onset glaucoma was significantly (P ¼ 0.018) more likely to be due to angle closure. With delayed-onset glaucoma, the filtration angle is open in 86% of eyes and significantly (P ¼ 0.006) more eyes in the delayed-onset group had microcornea. Conclusions Performing cataract surgery very early in life in microphthalmic eyes and leaving residual lens material increases the risk for glaucoma. We recommend a prophylactic iridectomy in eyes at risk for pupillary block. Eyes with delayed-onset glaucoma have open filtration angles but with findings consistent with incomplete development of filtration structures. Early age at cataract extraction and microcornea are risk factors for delayed-onset glaucoma.

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Pseudophakic Pupillary-Block Glaucoma in Children

Cited by 27 publications

References 16 publications

Comparison of Delayed-Onset Glaucoma and Early-Onset Glaucoma after Infantile Cataract Surgery

Comparison of Delayed-Onset Glaucoma and Early-Onset Glaucoma after Infantile Cataract Surgery

Use of intraocular lenses in children with traumatic cataract in south India

The aetiology in paediatric aphakic glaucoma

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