The natural history of glaucoma and ocular hypertension after pediatric cataract surgery.
BACKGROUND
We sought to define the prevalence and natural history of ocular hypertension and glaucoma for at least a 10-year period after pediatric cataract surgery.


METHODS
We conducted a prospective observational study of patients who received pediatric cataract surgery. Inclusion criteria included 2 directed ophthalmologic examinations performed at a minimum of 5 and 10 years after surgery.


RESULTS
A total of 63 patients (22 with bilateral cataracts and 41 with unilateral cataracts) were examined at a median of 15.1 year (range, 10.3-21.3 years) after surgery. A majority of the subjects had glaucoma or ocular hypertension (ie, 59%; 37/63). Nineteen percent (12/63) had glaucoma (5/22 with bilateral cataracts and 7/41 with unilateral cataracts). Approximately half (7/12) had developed glaucoma during the first 5-year observational period and the remainder (5/12) developed it during the following observational period. Forty percent (25/63) of the patients had ocular hypertension in at least one aphakic eye (9/23 with bilateral cataracts and 16/40 with unilateral cataracts). The rate of progression from ocular hypertension to glaucoma over a mean observational period of 7.2 years (range, 6.2-8.1 years) was 23% (5/22).


CONCLUSIONS
Patients who receive surgery for pediatric cataracts are at very high risk of developing ocular hypertension and glaucoma. Patients can develop late-onset glaucoma and ocular hypertension more than 10 years after surgery. Years of ocular hypertension may precede the diagnosis of late-onset glaucoma.
Egbert
James E
JE
Department of Surgery, Division of Ophthalmology, Santa Clara Valley Medical Center, San Jose, California, USA. James.Egbert@hhs.co.santa-clara.ca.us
Christiansen
Stephen P
SP
Wright
Martha M
MM
Young
Terri L
TL
Summers
C Gail
CG
D000293:Adolescent; D002387:Cataract Extraction; D002648:Child; D005500:Follow-Up Studies; D005901:Glaucoma / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008910:Minnesota / Q000453:epidemiology; D009798:Ocular Hypertension / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors