Cataract surgery in childhood poses increased risk of late-onset glaucoma

Children who undergo cataract surgery appear to be at risk of having glaucoma later in life, according to a study.

For the study, researchers looked at 68 patients (133 eyes) from a large family with hereditary childhood cataract. These patients underwent cataract surgery before 18 years of age.

An ophthalmologic examination was performed in order to determine the presence of glaucoma or ocular hypertension (OHT). Patients who opted out of the examination contributed data using a medical journal that the patients completed with their treating ophthalmologist. Survival analysis was used to determine the risk of long-term glaucoma, while a Cox proportional hazards regression model was used to evaluate risk factors.

Cataract surgery was performed at a median age of 7 years. The median follow-up time after cataract surgery to glaucoma/OHT or the latest ophthalmologic examination was 35 years.

Of the patients, 12 (18 eyes) had incident glaucoma and five (eight eyes) had incident OHT, corresponding to 15 patients with glaucoma/OHT. For patients who were free of glaucoma before 18 years of age, the long-term risk of glaucoma/OHT at the age of 70 years was 47.7 percent (95 percent confidence interval, 21.8–70.9).

No clear associations were found between glaucoma/OHT and sex, age at surgery, number of ocular interventions before 18 years of age, or glaucoma after cataract surgery in a first-degree relative.

The findings underscore the importance of regular lifelong follow-up among people who received cataract surgery in childhood to ensure early diagnosis of glaucoma and prevent extensive vision loss.