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D.S. Walton, L. Bhatia, E. Halpern, T. Chen; Risk Factors for the Development of Aphakic Glaucoma after Congenital Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2006;47(13):625.
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It is well known that early age at time of lensectomy surgery increases one’s risk of developing aphakic glaucoma. However, it is controversial whether there is a specific time period during the first year of life after which performing lensectomy surgery has a lower risk of aphakic glaucoma development. Statistical analysis was done to determine risk factors for the development of aphakic glaucoma after pediatric lensectomy.
A retrospective chart review was done of all patients seen by a pediatric glaucoma specialist (DSW) at the Massachusetts Eye and Ear Infirmary from 1970 to 2003. Patients were included if they had congenital cataract surgery by either DSW or a referring ophthalmologist. Cataracts were defined as congenital if they were identified within the first 6 months of life, were dominantly inherited, or were of the lamellar type. Aphakic glaucoma was defined as having repeated intraocular pressures greater than 25 mmHg after congenital cataract surgery. Goldmann or Perkins applanation tonometry was used to determine eye pressures. Patients were excluded if they had any conditions which independently are associated with glaucoma. Statistical analysis was performed using SAS software by one of the authors (EFH).
Three hundred sixty eight (368) eyes of 258 patients were included in the study. Two hundred sixteen of these eyes (58.7%) of 150 patients developed aphakic glaucoma. Risk factors of greatest significance (p<0.0001) included having lensectomy within the first year of life and the development of post–operative complications.
No specific age for lensectomy during that first year of life was associated with a decreased risk for aphakic glaucoma development. Surgery for congenital cataracts should not be delayed if the only reason for delay is to prevent the development of aphakic glaucoma.
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