J Korean Ophthalmol Soc > Volume 59(6); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(6):569-576.
DOI: https://doi.org/10.3341/jkos.2018.59.6.569    Published online June 15, 2018.
Risk Factors of Secondary Glaucoma after Congenital Cataract Surgery in Korean Patients.
Ga In Lee, Jong Chul Han, Si Bum Kim, Eun Jung Lee, Chang Won Kee
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ckee@skku.edu
한국인에서 선천백내장수술을 받은 환자들의 녹내장 발생 위험인자에 대한 분석
이가인⋅한종철⋅김시범⋅이은정⋅기창원
성균관대학교 의과대학 삼성서울병원 안과학교실
Correspondence:  Chang Won Kee,
Email: ckee@skku.edu
Received: 30 March 2017   • Revised: 19 October 2017   • Accepted: 15 December 2017
Abstract
PURPOSE
To assess the risk of development of secondary glaucoma after congenital cataract surgery using a long-term follow-up study. METHODS: In total, 148 eyes of 91 patients who underwent congenital cataract surgery at our hospital or other hospitals were included in a retrospective chart review. A diagnosis of secondary glaucoma was made if the intraocular pressure (IOP) exceeded 21 mmHg and the corneal diameter, axial length, or the cup-to-disc ratio increased, or surgery was performed to control the IOP. To analyze the clinical features and risk factors of secondary glaucoma, we evaluated the mean age at cataract surgery, binocularity, presence of a nuclear cataract, methods of cataract surgery, presence of an intraocular lens (IOL), duration of diagnosis of secondary glaucoma after cataract surgery, duration of follow-up, recent best-corrected visual acuity, and refractive errors. RESULTS: Thirty-five eyes (23.6%) were diagnosed with secondary glaucoma as a complication of congenital cataract surgery. Of these, 11 eyes (31.4%) were treated with glaucoma surgery a mean of 3.4 times. The mean duration from congenital cataract surgery to diagnosis of glaucoma was 112.2 ± 113.1 months. Patients with aphakia had a higher risk of developing secondary glaucoma compared with patients undergoing primary IOL implantation (p = 0.001). Younger age (<3 months at surgery), a nuclear cataract, and aphakia were risk factors for the development of secondary glaucoma (p = 0.03, p = 0.006, and p < 0.001, respectively), and the risk of developing secondary glaucoma increased with secondary IOL implantation (p = 0.052). CONCLUSIONS: Secondary glaucoma after congenital cataract surgery was more common in patients with secondary IOL implantation, aphakia, a younger age (<3 months), and a nuclear cataract. Patients who underwent congenital cataract surgery had an increased risk for developing secondary glaucoma. Long-term monitoring of the IOP and optic nerve is therefore required for these patients.
Key Words: Aphakia;Congenital cataract surgery;Primary intraocular lens (IOL) implantation;Secondary glaucoma


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