Visual and surgical outcomes of childhood glaucoma following cataract surgery

J AAPOS. 2024 Oct;28(5):103993. doi: 10.1016/j.jaapos.2024.103993. Epub 2024 Sep 13.

Abstract

Purpose: To evaluate frequency of surgery and post-treatment outcomes in glaucoma following cataract surgery (GFCS).

Methods: The medical records of patients with GFCS were reviewed retrospectively. Lensectomy and glaucoma surgery details and final examination findings were collected. Inclusion criteria included history of lensectomy at <1 year of age, diagnosis of glaucoma, and at least 1 year of follow-up.

Results: Of 169 eyes of 127 GFCS patients (66 male, 58 bilateral cases), 88 eyes (52%) of 73 (57%) patients underwent glaucoma surgery (median, 3.5 years of age at first glaucoma surgery; median of two glaucoma surgeries). At final follow-up (mean, 13.6 ± 7.0 years), eyes requiring glaucoma surgery had worse visual acuity (P = 0.01) and greater cup:disk ratio (P < 0.01). GFCS patients with history of bilateral congenital cataracts had better visual acuity in affected eyes than those with history of unilateral congenital cataract (P < 0.01). Angle surgery (n = 56), Baerveldt devices (n = 38), Ahmed valves (n = 19), and cycloablation (n = 21) showed 1-year survival rates between 64% and 75%. Baerveldt implants showed the highest 5- and 10-year survival rates, at 65% and 43%, respectively.

Conclusions: More than 50% of eyes with GFCS in our study cohort required at least one glaucoma surgery. Glaucoma surgery and history of unilateral cataract were associated with worse visual acuity outcomes.

MeSH terms

  • Adolescent
  • Cataract Extraction*
  • Cataract* / complications
  • Cataract* / congenital
  • Child
  • Child, Preschool
  • Female
  • Filtering Surgery / methods
  • Follow-Up Studies
  • Glaucoma Drainage Implants*
  • Glaucoma* / etiology
  • Glaucoma* / physiopathology
  • Glaucoma* / surgery
  • Humans
  • Infant
  • Intraocular Pressure* / physiology
  • Male
  • Postoperative Complications
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity* / physiology