Visual outcomes, challenges in pediatric cataract surgery after prior glaucoma surgery

Pediatric patients undergoing cataract surgery after prior glaucoma surgery can experience challenges such as capsulorrhexis and intraocular lens (IOL) instability, according to a study.

The retrospective study assessed outcomes in 20 eyes from 16 children who underwent cataract surgery post-glaucoma filtration surgery between January 2007 and December 2019.

Most patients initially underwent trabeculectomy and trabeculotomy (14 eyes). The most common cataract surgery was lens aspiration with posterior chamber IOL implantation (9 eyes), and median patient age at time of cataract surgery was 6.2 years.

The most common challenges cataract surgery were difficulty in capsulorrhexis (10 eyes) and extension of primary posterior capsulotomy (6 eyes).

At final follow-up, 8 eyes had experienced improved visual acuity, 5 eyes had stable visual acuity, and 5 eyes had decreased visual acuity.

Twelve eyes underwent IOL implantation (9 and 3 ciliary sulcus), and no in-the-bag IOLs had decentration of IOL. Two years after surgery, median postoperative intraocular pressure (P=.12) and median number of postoperative antiglaucoma medications (P=.13) were stable compared with preoperative values. Two eyes developed retinal detachment postoperatively.

The researchers concluded that visual outcomes were “reasonably good” in this study.

Reference

Badakere A, Badakere SV, Aijaz SK, et al. Intraoperative challenges and outcomes of pediatric cataract surgery following glaucoma filtering surgery. Int Ophthalmol. 2024;44(1):231. doi:10.1007/s10792-024-03116-7