Glaucoma after Pediatric Lensectomy/Vitrectomy

Simon, John W.; Mehta, Nalin J.; Simmons, Steven T.; Catalano, Robert A.; Lininger, Lloyd

doi:10.1016/s0161-6420(91)32235-8

Cited by 149 publications

(119 citation statements)

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“…Glaucoma developing after early cataract surgery is more problematic (Phelps & Arafat 1977;Chrousos et al 1984;Simon et al 1991;Parks et al 1993;Mills & Robb 1994;Egbert et al 1995;Walton 1995). It can occur soon after surgery as a result of pupil block or several years later with an open, but abnormal angle (Russell-Eggitt & Zamiri 1997).…”

Section: Discussionmentioning

confidence: 99%

“…Open angle glaucoma can develop slowly during years and decades after cataract surgery (Phelps & Arafat 1977, Russell-Eggitt & Zamiri 1997. The longer the follow-up the higher glaucoma prevalence is to be expected (Simon et al 1991). It is therefore important to stress that a lifelong follow-up of these patients is essential.…”

Section: Discussionmentioning

confidence: 99%

“…It is also important to diagnose and treat complications such as after-cataract and secondary glaucoma as soon as possible to avoid deprivation amblyopia or damage of the optic nerve. Both open-angle and closedangle glaucoma occur after successful surgery for congenital cataracts and the incidence remains alarmingly high (Phelps & Arafat 1977;Keech et al 1989;Simon et al 1991;Mills & Robb 1994).…”

Section: Introductionmentioning

confidence: 99%

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Complications after early surgery for congenital cataracts

Lundvall

Zetterström

1999

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To study the type and frequency of complications requiring additional surgery in infants operated on for congenital cataract before 12 months of age. Methods: The medical records of 57 infants who underwent surgery for unilateral and bilateral congenital cataracts during a five-year-period were reviewed retrospectively. The follow-up period ranged from 9 to 70 months with a mean of 37 months. Cataract extraction was performed on 83 eyes. Results: Thirty-eight operations for after-cataracts were performed on 32 out of 83 eyes. Fourteen vitrectomies were made on 11 eyes because of pupillary block glaucoma. Glaucoma requiring trabeculectomy developed in eight eyes 2 to 14 months after cataract extraction. This type of glaucoma occurred almost exclusively in eyes operated on during the first two months of life. Conclusion: Complications requiring additional surgery are very common in infants operated on for congenital cataracts during the first year of life. Glaucoma requiring trabeculectomy developed particularly in infants who had their cataract extraction very early. Glaucoma development was not more common in infants operated on for after-cataract.Key words: infant -cataract surgery -complications -aphakic glaucoma -after-cataract.Acta Ophthalmol. Scand. 1999: 77: 677-680 Copyright c Acta Ophthalmol Scand 1999. ISSN 1395-3907 C ataract is the most important cause of treatable childhood blindness (Foster et al. 1997). The visual outcome in infants undergoing surgery for congenital cataract has improved dramatically since the advent of modern surgical techniques and the realisation that early intervention and immediate optical correction can prevent otherwise irreversible deprivation amblyopia (Taylor 1979;Jacobson et al. 1981). However, it is extremely important that the cataract extraction and the correction of aphakia are performed early -within the first months of life Rogers et al. 1981;Gelbart et al. 1982;Parks 1982;Birch & Stager 1988;Drummond et al. 1989;Kugelberg 1992). It is also important to diagnose and treat complications such as after-cataract and secondary glaucoma as soon as possible to avoid deprivation amblyopia or damage of the optic nerve. Both open-angle and closedangle glaucoma occur after successful surgery for congenital cataracts and the incidence remains alarmingly high (Phelps & Arafat 1977;Keech et al. 1989;Simon et al. 1991;Mills & Robb 1994).The aim of this retrospective study was to determine the type and incidence of complications requiring additional surgery in infants who had undergone cataract extraction prior to 12 months of age. Material and MethodsThe medical records of all infants who underwent surgery for congenital cataract before 12 months of age at St. Erik's Eye Hospital during the five-year period from October 1991 to August 1996 were reviewed retrospectively. Seventy-five percent of the operations were performed by the same surgeon, the remaining twenty-five percent by three other surgeons.The surgical technique of the cataract extraction was th...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Complications after early surgery for congenital cataracts

Lundvall

Zetterström

1999

Acta Ophthalmologica Scandinavica

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“…3 Risk factors for aphakic glaucoma such as microcornea, 4,5 poor pupil dilation, 6 early surgery, 6,7 the need for secondary surgery 8,7 and type of cataract 5 are well documented. However, the role of posterior capsule integrity and intraocular lens implantation is less clear.…”

Section: Papadopoulos and Pt Khawmentioning

confidence: 99%

“…Support for this in the literature is inconclusive because of the shorter follow-up for the lensectomy and vitrectomy technique vs simple aspiration. 3,8 Asrani et al 1 suggest that primary posterior chamber intraocular lens implantation may decrease the incidence of open-angle glaucoma in congenital and development cataracts, but again with a short follow-up.…”

Section: Papadopoulos and Pt Khawmentioning

confidence: 99%

Meeting the challenge of glaucoma after paediatric cataract surgery

Papadopoulos

Khaw

2003

Eye

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Aphakic Glaucoma After Congenital Cataract Surgery

Chen¹

2004

Arch Ophthalmol

123

132

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To describe the largest series of patients who developed aphakic glaucoma after lensectomy for congenital cataracts. Methods: A retrospective review was performed of all patients seen by a pediatric glaucoma specialist between October 1, 1970, and November 30, 2002. Patients with intraocular pressures greater than 25 mm Hg after lensectomy were studied. Patients with either conditions independently associated with glaucoma or any signs of glaucoma before lensectomy were excluded. Results: We studied 170 eyes of 117 patients. The mean±SD follow-up period was 8.6±7.6 years. The most common cataract types were complete (40.8%) and nuclear (22.5%). For the lensectomies, 103 eyes underwent modern vitrectomy techniques, and 10 underwent older techniques. Lensectomies were performed in 80.6% of eyes before age 1 year. Onset of glaucoma after lensectomy was by 1 year in 37.1% of eyes, by 6 years in 75.9%, and by 33 years in 100%. Of eyes that had gonioscopy, 93.9% had open angles. Glaucoma surgery was needed in 57.1% of eyes. The median final visual acuity was 20/400. Conclusions: Most cases of aphakic glaucoma are of the open-angle type. Various risk factors are suggested, and the prognosis is guarded. Lifelong follow-up is needed to screen for glaucoma.

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Glaucoma after Pediatric Lensectomy/Vitrectomy

Cited by 149 publications

References 6 publications

Complications after early surgery for congenital cataracts

Complications after early surgery for congenital cataracts

Meeting the challenge of glaucoma after paediatric cataract surgery

Aphakic Glaucoma After Congenital Cataract Surgery

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