Abstract
Purpose :
To estimate the incidence of glaucoma and ocular hypertension after congenital cataract surgery and to identify risk factors associated with its development
Methods :
Retrospective review at a single tertiary care center’s pediatric ophthalmology clinic identified 38 eyes of 28 pediatric patients who underwent surgery for congenital cataracts between February 2010-March 2021. Inclusion criteria included congenital cataract surgery within the first year of life and patients with a minimum of 1-year postoperative follow-up. Exclusion criteria included preoperative evidence of glaucoma, ocular hypertension, IOP elevation, glaucoma suspect diagnosis, history of trauma, uveitis, prior ocular surgery, anterior segment dysgenesis, syndromic cataracts, or secondary cataracts. The outcome measures include the development of secondary glaucoma or ocular hypertension and an analysis of potential risk factors such as gender, laterality, horizontal corneal diameter, axial length, and central corneal thickness. Time-to-event analysis was used to estimate the incidence of glaucoma and ocular hypertension. Potential risk factors were evaluated using Cox regression.
Results :
38 eyes met the eligibility criteria for this analysis and contributed a median follow-up of 27.27 eye-months (range 12-101.03 months). Overall, 9 eyes (24%) developed glaucoma or ocular hypertension over 101 months. The Kaplan-Meier estimated incidence of glaucoma at 2 years was 4% (95% CI 0.01-0.23); by year 5, 14% (95% CI 0.05-0.39); and by year 8, 39% (95% CI 0.16-0.74). Cox proportional hazard models did not find statistically significant risk factors. However, there is a tendency for smaller horizontal corneal diameters (HR 0.71, 95% 0.34-1.4) and axial lengths (HR 0.95, 95% 0.56-1.6) to have less risk of developing glaucoma
Conclusions :
The incidence of glaucoma and/or ocular hypertension after congenital cataract surgery increases over time and can develop several years after surgery in a significant percentage of patients. Therefore, signs of glaucoma should be looked for during follow-up visits. A limitation of this study is the small sample size due to the strict inclusion criteria. Future studies are needed to identify potential risk factors
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.