Study highlights visual acuity and surgical outcomes in children with glaucoma following cataract surgery
More than 50% of children with glaucoma following cataract surgery required at least one glaucoma surgery, and those who underwent surgery, particularly those with unilateral congenital cataracts, had worse visual outcomes compared to those with bilateral cataracts, according to a poster presented at AAO 2024. Glaucoma surgery and the number of surgeries were significant factors impacting visual acuity.
The retrospective study reviewed the visual acuity (VA) and surgical outcomes of children with glaucoma following cataract surgery, analyzing 169 eyes from 127 patients. The study focused on patients who underwent lensectomy before 1 year of age, with a follow-up of over 1 year.
Key findings include:
- Over 50% of eyes (88 eyes) required at least 1 glaucoma surgery, with a median age of 3.5 years at the time of the first surgery.
- Eyes that underwent glaucoma surgery had significantly worse VA at final follow-up (average 13.6 years), as well as a higher cup-to-disc ratio.
- Children with bilateral congenital cataracts had better VA outcomes compared to those with unilateral cataracts.
- A linear association was observed between the number of surgeries and VA in bilateral cases, but not in unilateral cases.
- Survival analysis of different glaucoma procedures showed varying 5-year success rates: Baerveldt devices (65%), angle surgery (51%), cycloablation (43%), and Ahmed implants (19%).
The study underscores that of children with glaucoma following cataract surgery often require multiple surgeries, with glaucoma and unilateral cataracts associated with poorer VA outcomes.
Reference
Bohnsack BL, et al. Outcomes of Childhood Glaucoma Following Cataract Surgery. Poster presented at: American Academy of Ophthalmology Annual Meeting; October 2024; Chicago.