A recent study published in JAMA Ophthalmology identified a potential correlation between cataract surgery and the development of glaucoma-related adverse events (AEs) in pediatric patients.
Tell me about the study.
Researchers from the Pediatric Eye Disease Investigator Group designed a clinical research registry to track the medical and ophthalmic data records of 810 children (1,049 eyes) under the age of 13 who had undergone either unilateral or bilateral lensectomy within the previous 45 days.
They studied the 5-year cumulative data of glaucoma-related AE development in the pediatric patients post-surgery as well as the associated risk of AE development within 5 years.
How was the presence of glaucoma determined?
Investigators defined glaucoma based on an IOP <21 mmHg and with the presence of either:
- Abnormal corneal enlargement
- Increased optic nerve cupping
- Medication use to lower IOP
- Previous glaucoma surgery
Glaucoma suspect was based on an IOP < 21 mg but with none of the aforementioned criteria.
Findings?
A total of 443 eyes (55% female; mean age of 0.89 [1.97] years) were aphakic following lensectomy, while 606 eyes (47% female; mean age of 5.65 [3.32] years) were pseudophakic.
Five-year cumulative data on glaucoma-related AEs included 29% (95% CI, 25%-34%) for aphakic eyes and 7% (95% CI, 5%-9%) for pseudophakic eyes. Only 3% (95% CI, 2%-5%) of pseudophakic eyes identified as glaucoma suspect.
What else?
A higher risk for glaucoma-related AEs among aphakic eyes was correlated with patients less than 3 months of age with an abnormal anterior segment, intraoperative complications when undergoing lensectomy, and bilaterality.
Any limitations?
The authors noted a lack of age overlap between patient cohorts; differing definitions and criteria for glaucoma in previous studies; a significant loss of completion for a complete 5-year follow-up; and an increased risk for glaucoma-related AEs in pediatric patients >3 months of age.
Take home.
According to investigators, the findings suggest that ongoing monitoring for potential glaucoma development in patients post-lensectomy is needed at any age.