Predictors Of Secondary Glaucoma After Congenital Cataract Surgery
Published 2023 - 41st Congress of the ESCRS
Reference: FP25.01 | Type: Free paper | DOI: 10.82333/qx8a-v784
Authors: Rodrigo Vilares Morgado 1 , Ana Margarida Ferreira* 1 , Gonçalo Godinho 2 , João Barbosa-Breda 1 , António Benevides-Melo 1 , Augusto Magalhães 1 , Sérgio Estrela-Silva 1
1Department of Ophthalmology,Centro Hospitalar Universitário S. João,Porto,Portugal, 2Department of Ophthalmology,Centro de Responsabilidade Integrada de Oftalmologia de Leiria,Leiria,Portugal
Purpose
To establish risk factors for developing secondary glaucoma or ocular hypertension (OHT) after congenital cataract surgery.
Setting
Single-center study conducted in a tertiary care university hospital, in the Department of Ophthalmology of Centro Hospitalar Universitário S. João.
Methods
Retrospective study of pediatric patients who underwent congenital cataract phacoemulsification from 2009 to 2019 in our department. Included patients had to present a minimum follow-up of 24 months. Demographic and clinical data (age at surgery, phakic status after surgery, need for surgical reinterventions, other ocular diseases, such as persistent fetal vasculature, anterior segment dysgenesis or microphthalmia, and systemic diseases) were collected. Our primary outcome was the development of secondary glaucoma or OHT. Secondary outcomes were the number of glaucoma medications required, need for glaucoma surgical treatment, the number of glaucoma surgeries required, final visual acuity (VA) and final intraocular pressure (IOP).
Results
110 eyes from 74 pediatric patients were included. Average surgery timing was 117.7 weeks of age [2-827], with 74 eyes (67.9%) undergoing surgery ≤12 weeks of age. Average follow-up was 132.9 months [32-481]. 50 eyes (45.5%) developed OHT/secondary glaucoma following surgery, of which 28 eyes (56%) required glaucoma surgery. Eyes who underwent cataract surgery ≤12 weeks of age presented a higher prevalence of glaucoma/OHT (68.6% vs. 33.8%; p=0.001), as did aphakic eyes (64.4% vs. 32%; p=0.001) and eyes with other ocular disorders (p=0.004). Surgery ≤12 weeks of age (p=0.044) and presence of other ocular diseases (p=0.023) remained significant predictors of development of secondary glaucoma/OHT in a multivariable logistic regression model.
Conclusions
Eyes who present other ocular disorders or who undergo congenital cataract surgery ≤ 12 weeks of age present an increased risk of developing secondary glaucoma/OHT. Aphakic eyes also present an increased risk of developing this outcome, but this might be explained in part due to the underlying concurrent ocular disorders who complicate cataract surgery and do not enable intraocular lens implantation during surgery.