BACKGROUND
It is well-known that lensectomy surgery during the first year of life increases one’s risk of aphakic glaucoma. However, it is controversial whether there is a specific time period during the first year of life after which performing lensectomy surgery has a lower risk of aphakic glaucoma development.
PATIENTS AND METHODS
A retrospective chart review was performed of all patients seen by a pediatric glaucoma specialist from 1970 to 2003. Patients were included in the study if they underwent congenital cataract surgery. Cataracts were defined as congenital if they were identified within the first 6 months of life, were dominantly inherited, or were of the lamellar type. Aphakic glaucoma was defined as having repeated intraocular pressures > 25 mm Hg after congenital cataract surgery. Patients were excluded if they had any conditions that were independently associated with glaucoma.
RESULTS
A total of 368 eyes of 258 patients were included in the study. Of these, 216 (58.7%) eyes of 150 patients developed aphakic glaucoma. Risk factors of greatest significance (P < .0001) included having lensectomy within the first year of life and the development of postoperative complications.
CONCLUSIONS
No specific age for lensectomy during the first year of life was associated with a decreased risk for development of aphakic glaucoma. Surgery for congenital cataracts should not be delayed if the only reason for delay is to prevent the development of aphakic glaucoma.
J Pediatr Ophthalmol Strabismus 2006;43:274-280.
AUTHORS
Drs. Chen and Walton are from the Glaucoma Service, Massachusetts Eye and Ear Infirmary, and Harvard Medical School, Boston, Massachusetts; Dr. Bhatia is from the Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee; and Dr. Halpern is from the Massachusetts General Hospital, Institute for Technology Assessment, Boston, Massachusetts.
Originally submitted August 2, 2005.
Accepted for publication December 22, 2005.
Address reprint requests to Teresa C. Chen, MD, Massachusetts Eye and Ear Infirmary, Glaucoma Service, 243 Charles Street, Boston, MA 02114.
Supported in part by the Blind Children’s Center and the Miles Pediatric Research Fund.
Presented in part at the American Glaucoma Society Meeting, March 2-5, 2006, Charleston, SC; and the Annual Meeting of the American Ophthalmological Society, May 20-24, 2006, Half Moon Bay, CA.
The authors have no industry relationships to disclose.
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