CME Article 

Glaucoma Following Infantile Cataract Surgery

Robert M. Saltzmann, MD; David R. Weakley, MD; Nalini K. Aggarwal, MD; Jess T. Whitson, MD

Abstract

Purpose:

To examine incidence, risk factors, and outcomes of glaucoma following infantile cataract extraction.

Methods:

A retrospective chart review of all patients who underwent cataract extraction between January 1, 1993, and December 31, 2006, at the Children’s Medical Center in Dallas.

Results:

Sixty-four eyes met inclusion criteria, of which 11 eyes (17.2%) developed glaucoma during a mean follow-up of 65.1 ± 4.3 months. Age younger than 3 months at cataract diagnosis (odds ratio 4.89, P = .05) or cataract extraction (odds ratio 4.4, P = .047) and the presence of anterior chamber anomalies (odds ratio 8.0, P = .01) were the only risk factors found to have statistical significance for the development of glaucoma. Eight of 11 eyes with glaucoma (72.2%) required at least one surgical intervention. Three of 10 eyes (30%) had a final best-corrected visual acuity below 20/400 and another 4 eyes (40%) demonstrated some degree of amblyopia.

Conclusion:

Despite modern microsurgical techniques, infantile cataract surgery continues to pose a risk of secondary glaucoma. This was particularly true when cataract was diagnosed and/or extracted in patients younger than 3 months of age. Most eyes that developed glaucoma required surgical management and visual outcomes continue to be poor in this group.

Authors

From the University of Texas Southwestern Medical Center (RMS, DRW, NKA, JTW); and the Children’s Medical Center (RMS, DRW, NKA, JTW), Dallas, Texas.

Supported in part by an unrestricted research grant from Research to Prevent Blindness, Inc., New York, New York.

The authors have no financial or proprietary interest in the materials presented herein.

Address correspondence to Jess T. Whitson, MD, c/o Department of Ophthalmology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9057.

Received: December 08, 2008
Accepted: February 24, 2010
Posted Online: June 23, 2010

10.3928/01913913-20100618-04

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