Risk of glaucoma
after pediatric cataract surgery
Birgitte Haargaard 1*,
Christian Ritz 2,
Anna Oudin 3,
Jan Wohlfahrt 3,
John Thygesen 4,
Thomas Olsen 5,
and
Mads Melbye 2
1 Epidemiology Research, Statens Serum Institut, Artillerivej 5, Copenhagen S, 2300, Denmark; Ophthalmology, Glostrup University Hospital, Copenhagen, Denmark
2 Epidemiology Research, Statens Serum Insitut, Copenhagen, Denmark
3 Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
4 Ophthalmology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
5 Ophthalmology, Aarhus University Hospital, Copenhagen, Denmark
* To whom correspondence should be addressed. E-mail: bgd{at}ssi.dk.
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Abstract |
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Purpose. To determine the risk of glaucoma following surgery of pediatric cataract and to evaluate risk factors for glaucoma.
Methods. A population-based cohort of all children in Denmark aged 0 and 17 years during the period 1977-2001, who underwent surgery for pediatric cataract, was es-tablished by retrospective chart review. Glaucoma cases were defined as cases re-quiring glaucoma surgery (trabeculectomy and/or diode laser transscleral cyclo-photocoagulation) and/or permanent medical therapy after cataract surgery.
Results. Out of 946 eyes (595 patients) undergoing pediatric cataract surgery, 72 eyes (48 patients) subsequently developed glaucoma. Early surgery (< 9 months of age) was associated with a 7.2-fold increased risk of glaucoma compared to late sur-gery (
9 months of age). Ten years after cataract surgery 31.9% (95% confidence interval, CI, 24.4-41.1) of children undergoing surgery before 9 months of age devel-oped glaucoma compared to 4.1% (95% CI, 2.4-6.8) of children aged 9 months at time of surgery. Glaucoma cases continued to occur also more than 10 years after cataract surgery. After adjusting for age at surgery, no other risk factor appeared im-portant.
Conclusions: The risk of glaucoma following surgery for pediatric cataract is sub-stantial and particularly high for those below 9 months of age at time of surgery. Be-cause the risk increase remains many years after surgery careful continuous monitor-ing for glaucoma is mandated.
Key Words:
cataract surgery, glaucoma, epidemiology
