Clinical analysis of the secondary glaucoma and postoperative visual acuity after infantile congenital cataract surgery

• Main Authors: Yan Zhang, Chao Jia, Fang-Shun Zhang, Jin-Yan Qi
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2021-09-01
• Series: Guoji Yanke Zazhi
• Subjects: congenital cataract; secondary glaucoma; visual acuity; infant
• Online Access: http://ies.ijo.cn/cn_publish/2021/9/202109026.pdf

AIM: To analyze correlation of secondary glaucoma and postoperative visual acuity after infantile congenital cataract surgery. METHODS: Retrospective case series. Totally 48 cases(86 eyes)were observed in our hospital from May 2006 to January 2018. All patients received intraocular lens(IOL)implantation with posterior continuous curvilinear capsulorhexies and anterior vitrectomy after cataract extraction. The best corrected visual acuity(BCVA)was determined, secondary glaucoma was evaluated during the 13a follow-up period. The independent samples t-test, Fisher exact test and multivariate Logistic regression were used to analyze the data.RESULTS: Thirteen eyes(15%)with secondary glaucoma postoperative BCVA(LogMAR)were 0.63±0.20. And 73 eyes(85%)without secondary glaucoma postoperative BCVA were 0.44±0.27, there was statistically significant difference in BCVA between the two groups(t=2.417, P<0.05). Glaucoma occurred in 29%, 18% and 3% of patients with cataract extraction ≤3mo, 3-12mo and >12mo, respectively. Fisher analysis there was statistically significant difference between operation age ≤3mo and >12mo(P<0.05). The difference of axial length(AL)and refraction diopter between with and without secondary glaucoma were statistically significant(t=-2.92, P=0.004). Multivariate Logistic regression analysis showed surgery age ≤12mo was the risk factor(OR=8.372, 95%CI: 1.033-67.864, P=0.047). Cataract surgery age below 12mo is 8.372 times the probability of secondary glaucoma than surgery age above 12mo.CONCLUSION: Most children can achieve good postoperative visual acuity and the secondary glaucoma occurred after surgery. The age of cataract surgery more than 12mo is a risk factor for postoperative secondary glaucoma, especially cataract surgery age below 3mo is much higher the probability of secondary glaucoma than above 12mo. Patients with secondary glaucoma have longer AL, smaller refraction diopter and more pronounced myopia drift than patients without secondary glaucoma.