Risk of aphakic glaucoma after pars plana-lensectomy with and without removal of the peripheral lens capsule

Abstract

Background The etiology of aphakic glaucoma is unclear. It has been suggested that remaining lens epithelium releases cytokines transducing trabecular meshwork cells. Therefore, we compared two cohorts of children undergoing lensectomy. In cohort 1, the entire lens including its capsule was removed, in cohort 2 the peripheral lens capsule was left intact, also to facilitate secondary intraocular lens implantation later on. Methods We included children with uni-or bilateral congenital cataract who underwent lensectomy during the first year of life with subsequent contact lenses fitting. Group 1 comprised 41 eyes, group 2 comprised 33 eyes. In group 1, the median age at surgery was 4.0 months in unilateral and 3.0 months in bilateral cases 1, in group 2, 8.1 months and 2.4 months, respectively. The mean follow-up was 12.8 years in group 1 and 9.3 years in group 2. All cases were analyzed for the prevalence of aphakic glaucoma, for visual acuity and for compliance in visual rehabilitation (contact lens/occlusion therapy). Results We found no significant difference in glaucoma prevalence between group 1 and group 2 (p = 0.68). The overall glaucoma rate was 26% after the mean follow-up of 11 years in both groups. In unilateral cases, the median visual acuity was logMAR 0.7 in both groups. In bilateral cases it was logMAR 0.4 in group 1 and logMAR 0.2 in group 2 (p = 0.05). Conclusions Leaving the peripheral lens capsule intact had no negative effect on the incidence of glaucoma and on resulting visual acuity.

Long‐term risk of glaucoma after cataract surgery in childhood

“…the risk glaucoma to 12%-58% (Belitsky et al, 2022;Chen et al, 2006;Egbert et al, 2006;Freedman et al, 2021;Magnusson et al, 2000;Murphy et al, 2019;Rabiah, 2004;Ruddle et al, 2013;Stech et al, 2019;Tadros et al, 2016). Many of these studies include children who had cataract surgery prior to 12 months of age, which is known to increase the risk of developing secondary glaucoma.…”

Development of a postoperative visual function rehabilitation compliance assessment scale for children with congenital cataract: a reliability and validity study

“…Congenital cataract is mainly treated by surgery to remove the lens [ 8 ]. Nevertheless, the extent of postoperative visual recovery hinges on a protracted and methodical course of visual function rehabilitation (VFR) [ 14 , 20 , 25 ]. VFR, following congenital cataract surgery, encompasses refractive correction, patching therapy, and amblyopia training therapy.…”

Develop and test the reliability and validity of the postoperative visual function rehabilitation compliance assessment scale for children with congenital cataract

“…The incidence of congenital cataract in China is 0.5‰~5.6‰, and Asia is the most common region of congenital cataract (Lenhart & Lambert, 2022). Congenital cataract is mainly treated by surgery to remove the lens (Eibenberger et al, 2021), but the postoperative visual recovery depends on long-term systematic visual function rehabilitation (Lagrèze, 2020;Stech et al, 2019;Yangzes et al, 2019). Visual function rehabilitation after congenital cataract surgery includes refractive correction, patching therapy and amblyopia training therapy.…”