Meeting the challenge of glaucoma after paediatric cataract surgery

Glaucoma and increased central corneal thickness in aphakic and pseudophakic patients after congenital cataract surgery

“…Primary posterior capsulectomy and anterior vitrectomy may increase the risk of late onset open angle glaucoma in paediatric aphakic glaucoma. 20 We speculate that vitreous factors alter the microstructure of the anterior segment and might even impair the normal maturation of the cornea. An IOL might serve as a barrier between the cornea and vitreous and, consequently, corneal and anterior segment changes do not occur when an IOL is implanted primarily.…”

Outcome of angle surgery in children with aphakic glaucoma

“…The diagnosis of aphakic glaucoma was on the basis of serial examinations and was defined as an intraocular pressure greater than 25 mm Hg with associated changes in corneal diameter or clarity, increased axial length, increased optic nerve cupping, or a combination of the above. 15 Surgical treatment was chosen when aphakic glaucoma was not adequately controlled with topical medications. Either goniotomy or trabeculotomy was performed depending on the different surgeon's standard first choice for surgical intervention during the time of this study.…”

“…[8][9][10][11][12][13] Various risk factors have been implicated, including early surgery, persistent fetal vasculature, congenital rubella syndrome, Lowe syndrome, microcornea, chronic inflammation, and retained lens material. [12][13][14][15][16][17][18] The treatment of glaucoma in children after lensectomy is often difficult and may require multiple modalities. Although medical treatment is often the first line of therapy, surgical intervention frequently is necessary for adequate control.…”

Management of childhood glaucoma

“…Acquired glaucoma following infantile lensectomy is a frequent complication and important cause of vision loss following successful lens removal [20]. Trabeculectomy is less successful than in other glaucoma patients [21].…”