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Gunilla Magnusson; The Swedish national paediatric cataract register (PECARE); incidence and onset of post-operative glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):167.
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Purpose: Swedish eye screening in maternity wards is effective and cataracts have been detected within 6 weeks of age in 75% of the children operated within the first year of life in the paediatric cataract register, (PECARE). Early surgery is recommended in the literature but at the same time a factor associated with development of postoperative glaucoma. The aim of the study is to report the cumulative incidence and time of onset of postoperative glaucoma in a cohort with early operated children.
Methods: Data were derived from the Paediatric Cataract Register (PECARE), Sweden. All children operated on between January 2007 and December 2014 who had registered follow-ups were included. Exclusion criterias were coexisting congenital glaucoma and cataract caused by uveitis or trauma. Two hundred and eighty-eight eyes of 207 children (81 bilateral cataract; 126 unilateral cataract) were included (106 girls; 101 boys), with median follow-up of 3.4 years (range 0.00 –9.53 years). Post-operative glaucoma was defined as early-onset glaucoma if diagnosed within one year after surgery and late-onset glaucoma if diagnosed one year after surgery.
Results: A majority of the eyes were operated within 3 months of age (58%, 168/288). Cumulative incidence of glaucoma was 27.4% for eyes (79/288) and 27.5% (57/207) for subjects. Median time to onset of glaucoma was 0.93 years (range 0.026 - 4.97 years) for eyes. Early onset glaucoma was defined for 91 % of the eyes diagnosed with glaucoma (72/79), and late-onset for 9 % (7/79).
Conclusions: Post-operative glaucoma still represent a major threat to visual development of children operated for congenital cataract. Long term follow-up studies are needed to evaluate whether very early surgery vs. early surgery trigger late-onset glaucoma to become early- onset, or not, and if so, the consequences.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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