Secondary Glaucoma Following Surgery for Congenital and Developmental Cataract in East Africa

Background: Cataract is a leading cause of childhood blindness in East Africa, and high quality surgical centers are increasingly responding to this challenge. Despite evidence concerning the ongoing risk of secondary glaucoma after lensectomy, little is known of the incidence of secondary glaucoma after pediatric cataract surgery in East Africa. We sought to evaluate the frequency and predictors of secondary glaucoma as well as the present adequacy of long term follow-up in this setting. Methods: We retrospectively reviewed the medical records of all children who underwent surgery for congenital or developmental cataract between 2003 and 2005 at the Kilimanjaro Christian Medical Centre. We calculated the incidence of secondary glaucoma for the cohort and utilized logistic regression to evaluate potential risk factors. Results: Cumulative incidence of glaucoma at 3 years was 6.46%, and the annual incidence rate was 2.01 cases per 100 operated eyes. Only total time of follow-up and absence of primary IOL implantation were significantly associated with postoperative glaucoma. Conclusion: As cataract surgical rates continue to increase and centers in East Africa progress toward the goals of VISION 2020, renewed effort must be directed toward the long term postoperative care of all children undergoing operation for pediatric cataract.Master of Public Healt