Risk Factors For Ocular Hypertension And Changes In Ocular Biometric Parameters Following Pediatric Lensectomy With Primary Intraocular Lens Implantation
Published 2025 - 43rd Congress of the ESCRS
Reference: PP11.16 | Type: Free paper | DOI: 10.82333/mwqa-d416
Authors: Ehud Assia* 1 , Avner Belkin 1
1Ein Tal Eye Center,Tel Aviv,Israel;Ophthalmology,Meir Medical Center,Kfar-Saba,Israel
Purpose
To investigate the risk factors associated with the development of ocular hypertension (OHT) and to examine the changes in ocular biometric parameters following pediatric lensectomy with primary intraocular lens (IOL) implantation.
Setting
Zhongshan Ophthalmic Center, Guangzhou, China.
Methods
Children diagnosed with unilateral or bilateral pediatric cataracts during May 2020 to November 2022, and underwent pediatric cataract extraction with primary intraocular lens implantation, were included in the study. Standardized eye examination, biometry and anterior segment optical coherence tomography (AS-OCT) were performed before cataract surgery. Intraocular pressure (IOP) was checked only 1 day postoperatively (POD1), followed by routine rechecks of IOP, AL and anterior segment parameters at 1 week, 1 month, 3 months, 6 months and 1 year postoperatively (POW1, POM1, POM3, POM6 and POY1, respectively).
Results
A total of 71 patients with 105 eyes were included in this study. 40 eyes (37.1%) developed OHT, predominantly within the first postoperative week. Cox multivariable analysis showed that correcting for the risk factors CCT <500 μm and age at surgery >8.5 years, patients with AOD500 <0.55 mm (HR: 2.35, 95% CI: 1.24, 4.44, P=.01), TIA250 <53.80° (HR: 2.05, 95% CI: 1.08, 3.86, P=. 03) and TIA500 <48.80° (HR: 2.54, 95% CI: 1.22, 5.28, P=.01) characteristics of patients at high risk of developing OHT postoperatively. Postoperative CCT (+10.89 μm, P<.01), ACD (+1.05 mm, P<.001) and ACA (+7.12 mm2, P<.01) showed a significant increasing trend over one year, whereas AOD250 (-.04 mm at 6 months, P<.01) showed a decreasing trend.
Conclusions
Preoperative CCT >550 μm, older age at surgery, and narrow anterior chamber angles independently predicted OHT after pediatric lensectomy with IOL implantation. Early postoperative IOP monitoring and evaluation of angle anatomy are critical for high-risk patients. These findings support tailored surveillance protocols to mitigate glaucoma risk.