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Age at time of cataract surgery associated with risk for glaucoma-related adverse events
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WASHINGTON — Younger age at time of cataract surgery in children younger than 13 years was associated with greater risk for development of glaucoma-related adverse events, according to a study presented here.
“The overall rate of a glaucoma-related [adverse event] within 1 year of cataract surgery is about 6%, with age less than 3 months conferring a higher risk after controlling for other factors,” Sharon F. Freedman, MD, told colleagues at the American Association for Pediatric Ophthalmology and Strabismus meeting.
The purpose of the nonrandomized observational study was to determine the incidence of glaucoma-related adverse events within 18 months after cataract surgery in a large cohort of children aged through 12 years who had undergone lensectomy and to determine risk factors for development of glaucoma-related adverse events in this cohort.
A total of 1,178 eyes were included in the analysis, and 1,084 (92%) of those eyes were examined within 18 months of cataract surgery.
Neither sex nor race was a significant factor in development of glaucoma adverse events. Preoperative IOP, either higher or lower than the median of 14 mm Hg, was not a significant factor and neither was eye size, that is, axial length longer or shorter than the median of 22 mm. Also not significant was the presence of traumatic cataract, unilateral or bilateral cataract, or need for anterior vitrectomy at surgery.
“The data suggest an effect between the presence of an anterior segment abnormality presurgery and glaucoma-related [adverse events] but do not reach the required P < .01 level of significance,” Freedman said. – by Patricia Nale, ELS
Reference:
Freedman SF. Risk of developing glaucoma/glaucoma suspect within 18 months after pediatric cataract surgery. Presented at: American Association for Pediatric Ophthalmology and Strabismus meeting; March 18-22, 2018; Washington.
Disclosure: Freedman reports no relevant financial disclosures.
Perspective
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Scott E. Olitsky, MD
The development of glaucoma following cataract surgery in the pediatric population can be a devastating event, and the risk has been well documented following congenital cataract surgery. This study employed the use of a cataract registry, which showed that the risk of developing glaucoma after surgery remains significant into the teenage years. The overall risk was 6% but increased to almost 16% in patients younger than 3 months of age at the time of surgery. This study demonstrates the usefulness of a robust registry system even for common procedures. Most likely other procedures in which a registry could be implemented would benefit from similar analysis. Most importantly, it can provide clinical information that physicians can use in helping to best counsel their patients.
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