Lifelong glaucoma surveillance needed after cataract removal in infancy

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After unilateral cataract removal in infancy, the risk of glaucoma-related adverse events increases with longer follow-up of children, according to a study in JAMA Ophthalmology.

In this randomized clinical trial, 114 infants with unilateral congenital cataracts who were randomized at the time of cataract surgery to primary intraocular lens (IOL) or aphakia (contact lens [CL]), were followed until they were 10.5 years old.

The risk of glaucoma after cataract removal increased with age, from 9% at 1 year, to 17% at 5 years, to 22% at 10 years for all eyes.

The risk of glaucoma and suspected glaucoma diagnosis after cataract surgery increased from 12% to 31% to 40% at 1 year, 5 years, and 10 years, respectively. At 10 years there was no significant difference for Risk of glaucoma and glaucoma plus glaucoma suspect diagnosis between the treatment groups.

Patients with glaucoma had a longer axial length compared with those with suspected glaucoma.

Freedman SF, Beck AD, Nizam A, et al. Glaucoma-related adverse events at 10 years in the infant aphakia treatment studyA Secondary Analysis of a Randomized Clinical Trial. JAMA Ophthalmol. Published online December 17, 2020. doi:10.1001/jamaophthalmol.2020.5664

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