Glaucoma-related adverse events in the Infant Aphakia Treatment Study: 1-year results

Allen D Beck, Sharon F Freedman, Michael J Lynn, Erick Bothun, Daniel E Neely, Scott R Lambert, Infant Aphakia Treatment Study Group, Scott R Lambert, Lindreth DuBois, Michael J Lynn, Betsy Bridgman, Marianne Celano, Julia Cleveland, George Cotsonis, Carey Drews-Botsch, Nana Freret, Lu Lu, Azhar Nizam, Seegar Swanson, Thandeka Tutu-Gxashe, E Eugenie Hartmann, Clara Edwards, Claudio Busettini, Samuel Hayley, Scott R Lambert, Edward G Buckley, David A Plager, M Edward Wilson, Michael J Lynn, Lindreth DuBois, Carolyn Drews-Botsch, E Eugenie Hartmann, Donald F Everett, Buddy Russell, Michael Ward, M Edward Wilson, Margaret Bozic, Deborah K VanderVeen, Theresa A Mansfield, Kathryn Bisceglia Miller, Stephen P Christiansen, Erick Bothun, Ann Holleschau, Jason Jedlicka, Patricia Winters, Jacob Lang, Elias I Traboulsi, Susan Crowe, Heather Hasley Cimino, Kimberly G Yen, Maria Castanes, Alma Sanchez, Shirley York, David T Wheeler, Ann U Stout, Paula Rauch, Kimberly Beaudet, Pam Berg, Scott R Lambert, Amy K Hutchinson, Lindreth DuBois, Rachel Robb, Marla J Shainberg, Edward G Buckley, Sharon F Freedman, Lois Duncan, B W Phillips, John T Petrowski, David Morrison, Sandy Owings, Ron Biernacki, Christine Franklin, David A Plager, Daniel E Neely, Michele Whitaker, Donna Bates, Dana Donaldson, Stacey Kruger, Charlotte Tibi, Susan Vega, David R Weakley, David R Stager Jr, Joost Felius, Clare Dias, Debra L Sager, Todd Brantley, Robert Hardy, Eileen Birch, Ken Cheng, Richard Hertle, Craig Kollman, Marshalyn Yeargin-Allsopp, Cyd McDowell, Donald F Everett, Allen D Beck, Allen D Beck, Sharon F Freedman, Michael J Lynn, Erick Bothun, Daniel E Neely, Scott R Lambert, Infant Aphakia Treatment Study Group, Scott R Lambert, Lindreth DuBois, Michael J Lynn, Betsy Bridgman, Marianne Celano, Julia Cleveland, George Cotsonis, Carey Drews-Botsch, Nana Freret, Lu Lu, Azhar Nizam, Seegar Swanson, Thandeka Tutu-Gxashe, E Eugenie Hartmann, Clara Edwards, Claudio Busettini, Samuel Hayley, Scott R Lambert, Edward G Buckley, David A Plager, M Edward Wilson, Michael J Lynn, Lindreth DuBois, Carolyn Drews-Botsch, E Eugenie Hartmann, Donald F Everett, Buddy Russell, Michael Ward, M Edward Wilson, Margaret Bozic, Deborah K VanderVeen, Theresa A Mansfield, Kathryn Bisceglia Miller, Stephen P Christiansen, Erick Bothun, Ann Holleschau, Jason Jedlicka, Patricia Winters, Jacob Lang, Elias I Traboulsi, Susan Crowe, Heather Hasley Cimino, Kimberly G Yen, Maria Castanes, Alma Sanchez, Shirley York, David T Wheeler, Ann U Stout, Paula Rauch, Kimberly Beaudet, Pam Berg, Scott R Lambert, Amy K Hutchinson, Lindreth DuBois, Rachel Robb, Marla J Shainberg, Edward G Buckley, Sharon F Freedman, Lois Duncan, B W Phillips, John T Petrowski, David Morrison, Sandy Owings, Ron Biernacki, Christine Franklin, David A Plager, Daniel E Neely, Michele Whitaker, Donna Bates, Dana Donaldson, Stacey Kruger, Charlotte Tibi, Susan Vega, David R Weakley, David R Stager Jr, Joost Felius, Clare Dias, Debra L Sager, Todd Brantley, Robert Hardy, Eileen Birch, Ken Cheng, Richard Hertle, Craig Kollman, Marshalyn Yeargin-Allsopp, Cyd McDowell, Donald F Everett, Allen D Beck

Abstract

Objectives: To report the incidence of glaucoma and glaucoma suspects in the IATS, and to evaluate risk factors for the development of a glaucoma-related adverse event in patients in the IATS in the first year of follow-up.

Methods: A total of 114 infants between 1 and 6 months of age with a unilateral congenital cataract were assigned to undergo cataract surgery either with or without an intraocular lens implant. Standardized definitions of glaucoma and glaucoma suspect were created and used in the IATS.

Results: Of these 114 patients, 10 (9%) developed glaucoma and 4 (4%) had glaucoma suspect, for a total of 14 patients (12%) with a glaucoma-related adverse event in the treated eye through the first year of follow-up. Of the 57 patients who underwent lensectomy and anterior vitrectomy, 5 (9%) developed a glaucoma-related adverse event; of the 57 patients who underwent an intraocular lens implant, 9 (16%) developed a glaucoma-related adverse event. The odds of developing a glaucoma-related adverse event were 3.1 times higher for a child with persistent fetal vasculature and 1.6 times higher for each month of age younger at cataract surgery.

Conclusions: Modern surgical techniques do not eliminate the early development of glaucoma following congenital cataract surgery with or without an intraocular lens implant. Younger patients with or without persistent fetal vasculature seem more likely to develop a glaucoma-related adverse event in the first year of follow-up. Vigilance for the early development of glaucoma is needed following congenital cataract surgery, especially when surgery is performed during early infancy or for a child with persistent fetal vasculature. Five-year follow-up data for the IATS will likely reveal more glaucoma-related adverse events.

Trial registration: clinicaltrials.gov Identifier: NCT00212134.

Source: PubMed

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