Multiple drugs, interventions needed to maintain vision in pediatric aphakic glaucoma

Pediatric patients who develop glaucoma following cataract surgery can achieve and maintain good visual outcomes, according to one retrospective study. However, the authors state that multiple IOP-controlling medications and surgeries may be necessary.

Rahul Bhola, MD, and colleagues at the University of Iowa Hospitals and Clinics in Iowa City reviewed the long-term visual outcomes for 55 eyes of 36 pediatric aphakic glaucoma patients followed for a mean 18.7 years. The researchers had excluded any patients who underwent cataract extraction after age 10 and who had other ocular conditions, systemic syndromes, traumatic cataracts, congenital glaucoma or less than 1 year of follow-up, according to the study.

At final follow-up, the researchers found that 54.5% of the patients had maintained a visual acuity (VA) of 20/40 or better, 34.5% had a VA of 20/50 to 20/200, and 11% had a VA below 20/200.

However, all patients required changes in their glaucoma medications during follow-up. Specifically, 34% of patients required up to two medication changes, 33% required three to five changes, and 33% required six or more changes, according to the study.

The authors noted that 36% of eyes required no more than two medications for more than 6 months. Of the remaining eyes, 33% required three medications, and 31% required four or more medications for more than 6 months.

Additionally, 15 of the 55 eyes (27%) required surgical intervention to control their glaucoma. Of these, six eyes (40%) required one glaucoma surgery, eight eyes (53%) required two to three surgeries, and one eye (7%) required up to six surgeries, according to the study.

The study was published in the Journal of the American Association of Pediatric Ophthalmology and Strabismus.