POSTOPERATIVE GLAUCOMA FOLLOWING CATARACT SURGERY IN CHILDREN
Published 2023
- 27th ESCRS Winter Meeting
Reference: O67
| Type: Free Paper Submission
| DOI:
10.82333/a5df-ef55
Authors:
Sara Ennaki* 1
, Zineb Hammoumi 1
, Naoual Mtalai 1
, Ghizlane Daghouj 1
, Loubna El Maaloum 1
, Bouchra Allali 1
, Asmaa El Kettani 1
1Centre Hospitalier Universitaire de Casablanca,CASABLANCA,Morocco
Purpose
Postoperative glaucoma in children undergoing cataract surgery is a complication that can threaten functional prognosis. The aim of this work is to investigate the prevalence of secondary glaucoma and its associated risk factors in children undergoing congenital cataract surgery.
Setting
Postoperative glaucoma in children undergoing cataract surgery is a complication that can threaten functional prognosis. The aim of this work is to investigate the prevalence of secondary glaucoma and its associated risk factors in children undergoing congenital cataract surgery.
Methods
A retrospective study was performed, spread over 8 years, from January 2014 to October 2021, in the pediatric ophthalmology department at the August 20 Hospital in Casablanca. It includes 516 eyes of children operated on for congenital cataract and aged under 16. Development of glaucoma was defined as IOP >22 mmHg, increased corneal diameter, increased cup to disc ratio, and reduced anterior chamber depth. We mainly evaluated the following risk factors: age at the time of surgery, unilateral or bilateral cataract, presence of microcornea, performance of posterior capsulotomy with anterior vitrectomy and primary implantation.
Results
306 patients with bilateral cataract and 210 with unilateral cataract underwent cataract extraction. Secondary glaucoma was diagnosed in 36 eyes (7%). 2% (10 eyes) of eyes with intraocular lens implantation and 5% (26 eyes) of aphakic eyes developed glaucoma after cataract surgery. The median time to onset is 3 years. The mean age at surgery for patients who developed glaucoma was 1.7 months. The micro-cornea is present in 20% of cases. Therapeutic management initially consists of hypotonic medical treatment. 16% of cases required the use of filtering surgery. 8% of cases evolved into refractory glaucoma.
Conclusion
Congenital cataract surgery at an early age increases the risk of developing glaucoma, whether the eye is aphakic or pseudophakic. The management of secondary glaucoma is heavy, the visual prognosis is compromised, hence the interest of long-term follow-up.