Risk Factors for the Development of Aphakic Glaucoma After Congenital Cataract Surgery

Purpose: It is well known that lensectomy surgery during the first year of life increases the 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. Methods: A retrospective chart review was done of all patients seen by a pediatric glaucoma specialist (D.S.W.) from 1970 to 2003. Patients were included if they had congenital cataract surgery performed by either D.S.W. or a referring ophthalmologist. 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 greater than 25 mm Hg after congenital cataract surgery. Patients were excluded if they had any conditions that independently are associated with glaucoma. Statistical analysis for risk factors for aphakic glaucoma development was done using SAS software. Results: Three hundred sixty-eight eyes of 258 patients were included in the study. Two hundred sixteen eyes (58.7%) of 150 patients developed aphakic glaucoma. Risk factors of greatest significance (P \u3c .0001) included having lensectomy within the first year of life and the development of postoperative complications. Conclusions: No specific age for lensectomy during that first year of life was associated with a decreased risk for aphakic glaucoma development. Surgery for congenital cataracts should not be delayed if the only reason for delay is to prevent the development of aphakic glaucoma