Incidence and predictors of glaucoma following surgery for congenital cataract in the first year of life in Victoria, Australia. (12th March 2013)

• Record Type: Journal Article
• Authors: Ruddle, Jonathan B; Staffieri, Sandra E; Crowston, Jonathan G; Sherwin, Justin C; Mackey, David A
• Is Part Of: Clinical & experimental ophthalmology. Volume 41:Number 7(2013)
• Page Start: 653
• Page End: 661
• Publication Date: 2013-03-12
• Subjects: Ophthalmology -- Periodicals; 617.7
• DOI: 10.1111/ceo.12067
• Languages: English
• ISSNs: 1442-6404

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="ceo12067-sec-0001" sec-type="section"> <title>Aim</title> <p>To determine the incidence and predictors of glaucoma following surgery for congenital and infantile cataract in an Australian population.</p> </sec> <sec id="ceo12067-sec-0002" sec-type="section"> <title>Design</title> <p>Retrospective cohort study.</p> </sec> <sec id="ceo12067-sec-0003" sec-type="section"> <title>Participants</title> <p>Infants (<12 months) having had lens extraction between January 1992 and May 2006, from two tertiary referral centres.</p> </sec> <sec id="ceo12067-sec-0004" sec-type="section"> <title>Methods</title> <p>Children with uveitis, anterior segment dysgenesis, aniridia, retinopathy of prematurity, and lens subluxation were excluded. Potential predictors of incident glaucoma were examined using Cox proportional hazards regression with adjustment for clustering between eyes.</p> </sec> <sec id="ceo12067-sec-0005" sec-type="section"> <title>Main Outcome Measures</title> <p>Incidence and predictors of secondary glaucoma.</p> </sec> <sec id="ceo12067-sec-0006" sec-type="section"> <title>Results</title> <p>One hundred and forty‐seven eyes of 101 patients (46 bilateral cataract; 55 unilateral cataract) were included, with median follow‐up of 9.9 years (range 1.2–18.9 years). Cumulative incidence of glaucoma was 32.0% for eyes (<italic>n</italic> = 47) and 30.7% (<italic>n</italic> = 31) for subjects. Incidence was higher in children with bilateral cataract (38.9 <italic>vs</italic>. 17.1%, <italic>p</italic> = 0.004). There were 3.9 cases of glaucoma per 100 person years of follow‐up, the incidence rate being highest for surgery performed in the first month of life. Children with glaucoma had longer median follow‐up (11.8 <italic>vs</italic>. 9.3 years, <italic>p</italic> = 0.005). Risk of glaucoma decreased with increasing months of age at operation: hazard ratio 0.79, 95% confidence interval 0.69–0.91, <italic>p</italic> = 0.001. Median visual acuity was worse in children with unilateral cataract (<italic>p</italic> < 0.001).</p> </sec> <sec id="ceo12067-sec-0007" sec-type="section"> <title>Conclusions</title> <p>We identified an increased risk of glaucoma when cataract surgery was performed in younger infants, and in those with bilateral cataract. As glaucoma may develop over a decade following lens extraction, life‐long surveillance is needed to prevent glaucoma‐associated vision loss.</p> </sec> </abstract>