Clinical Ophthalmology (Jul 2023)

Prevalence of Glaucoma Following Paediatric Cataract Surgery in an Australian Tertiary Referral Centre

  • Wood A,
  • Lim B,
  • Matthews J,
  • Karaconji T,
  • Zagora SL,
  • Jamieson RV,
  • Grigg JR,
  • Jones M,
  • Rowe N,
  • Hing S,
  • Donaldson C,
  • Smith JE

Journal volume & issue
Vol. Volume 17
pp. 2171 – 2179

Abstract

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Alanna Wood,1,2 Benjamin Lim,2 Jim Matthews,3 Tanya Karaconji,1,2 Sophia L Zagora,1,2 Robyn V Jamieson,1,2,4,5 John R Grigg,1,2,4 Michael Jones,2,* Neil Rowe,2,* Stephen Hing,2,* Craig Donaldson,2,* James EH Smith2,* 1Save Sight Institute, Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, Sydney, NSW, Australia; 2Department of Ophthalmology, The Children’s Hospital at Westmead, Sydney, Australia; 3Sydney Informatics Hub, The University of Sydney, Sydney, NSW, Australia; 4Eye Genetics Research, The Children’s Hospital at Westmead, Save Sight Institute, Children’s Medical Research Institute, University of Sydney, Sydney, NSW, Australia; 5Disciplines of Genetic Medicine, and Child and Adolescent, Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia*These authors contributed equally to this workCorrespondence: Alanna Wood, Tel +61 404 072 401, Email [email protected]; [email protected]: Secondary glaucoma following childhood cataract surgery remains the most common complication in the paediatric population. This study aimed to determine the incidence, time to progression and risk factors associated with the development of secondary glaucoma following childhood cataract surgery in a paediatric population. Outcome measures were the detection of secondary glaucoma, postoperative time frame to development of glaucoma and risk factors in its development.Patients and Methods: A retrospective case series was conducted between 2003 and 2017 at a tertiary children’s hospital in Sydney. The patient population included those 16 years or less of age who underwent congenital cataract extraction, with or without an intraocular lens implantation and who had been followed up for a minimum of six months following surgery. Patients were excluded if they had cataract aetiology other than congenital idiopathic cataract. Multivariate Cox Regression analysis was used to determine relevant risk factors.Results: A total of 320 eyes in 216 patients were included in the study. Secondary glaucoma developed in 11.9% of eyes. In those that developed secondary glaucoma, the average time to onset from surgery was 3.2 years (median 2.75 years). The mean age of diagnosis of secondary glaucoma was 4.58 years (median 3.5 years, range 2.5 months to 13.23 years). Microcornea was the only adverse characteristic significantly associated with an increased risk of secondary glaucoma (HR 6.30, p 0.003).Conclusion: Despite modern surgical techniques, glaucoma remains a significant long-term sequela in children following cataract surgery.Keywords: secondary glaucoma, paediatric, childhood cataract surgery, glaucoma following cataract surgery

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