Frequency and predictors of glaucoma after pediatric cataract surgery

Am J Ophthalmol. 2004 Jan;137(1):30-7. doi: 10.1016/s0002-9394(03)00871-7.


Purpose: To determine the frequency of and identify predictors of chronic glaucoma after pediatric cataract surgery.

Design: Interventional case series.

Methods: Retrospective review at an eye hospital identified 570 eyes among 322 patients who underwent limbal-approach surgery without intraocular lens implantation at age <or=16 years for cataract unassociated with other ocular anomalies aside from microcornea. Patients had a minimum of 5 years' postoperative follow-up, which included intraocular pressure measurement. The outcome measure was the presence or absence of postcataract surgery glaucoma, defined as intraocular pressure >or=26 mm Hg, as measured on at least two occasions.

Results: Mean follow-up was 9.0 +/- 3.1 years (median, 8.1 years; range, 5.0-18.3 years). Glaucoma developed in 118 of 570 patients' eyes (21%), including 101 of 272 (37%) undergoing surgery at <or=9 months of age and 17 of 298 (6%) undergoing surgery thereafter. Multivariable Cox proportional hazards regression analysis with adjustment for potential intrasubject correlation identified surgery at <or=9 months of age (hazard ratio [HR], 3.8; 95% confidence interval [CI], 1.8-7.7; P <.001), secondary membrane surgery (HR, 2.6; 95% CI, 1.3-5.3; P =.006), microcornea (HR, 1.9; 95% CI, 1.2-3.1; P =.008), and primary posterior capsulotomy/anterior vitrectomy (HR, 10.7; 95% CI, 1.4-80.6; P =.02) as predictors of glaucoma.

Conclusions: Chronic glaucoma is common after cataract surgery performed at or before, but not after, a certain age in childhood. The data suggest that this age threshold is 9 months, but a true threshold occurring at a somewhat later age cannot be fully excluded.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Cataract Extraction / adverse effects*
  • Child
  • Child, Preschool
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Glaucoma / diagnosis
  • Glaucoma / epidemiology*
  • Glaucoma / etiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Intraocular Pressure
  • Male
  • Postoperative Complications*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors