Ocular hypertension after pediatric cataract surgery: baseline characteristics and first-year report

Haotian Lin, Weirong Chen, Lixia Luo, Xinyu Zhang, Jingjing Chen, Zhuoling Lin, Bo Qu, Jiao Zhan, Danying Zheng, Xiaojian Zhong, Zhen Tian, Yizhi Liu, Study Group of CCPMOH, Haotian Lin, Weirong Chen, Lixia Luo, Xinyu Zhang, Jingjing Chen, Zhuoling Lin, Bo Qu, Jiao Zhan, Danying Zheng, Xiaojian Zhong, Zhen Tian, Yizhi Liu, Study Group of CCPMOH

Abstract

Monitoring intraocular pressure (IOP) is essential for pediatric cataract treatment but always difficult due to lack of cooperation in young children. We present the baseline characteristics and the first-year results of a long-term prospective cohort study, which are aimed to determine the relationship of the incidence of ocular hypertension (OH) in children after cataract surgery during the first-year period and the risk of developing late-onset glaucoma. Children were included with the following criteria: they were ≤10 years old and scheduled to undergo cataract surgery with/without intraocular lens implantation; they were compliant with our follow-up protocol, which included monitoring IOP using a Tono-Pen under sedation or anesthesia. Incidence of OH, peak OH value, OH onset time and OH duration within a 12-month period following surgery were measured. In brief, 206 patients (379 eyes) were included and OH developed in 66 of 379 (17.4%) eyes. The mean follow-up period was 14.0±3.2 months (median, 12 months; range, 10-16 months). Moreover, 33 of 196 (16.8%) aphakic eyes and 33 of 183 (18.0%) IOL eyes were diagnosed with OH. The peak OH onset times were at 1-week (34/66, 51.5%) and 1-month (14/66, 21.2%) appointments postsurgery. The peak IOP value in the OH eyes was 29.9±7.5 mmHg (median, 29 mmHg; range, 21-48 mmHg). The duration of OH was 30.9±31.2 days (median, 30 days; range, 3-150 days). OH recurred in 13 eyes with a history of OH diagnosed within 1 month postsurgery (13/54, 24.1%), which needed temporary or long term use of antiglaucoma medications. In conclusion, the incidence of OH in children after cataract surgery was 17.4% during the first-year period. Children who have suffered elevated IOP in the first year after cataract surgery should be followed closely to determine if there is an increased risk of developing late-onset glaucoma.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Flow chart for patient selection…
Figure 1. Flow chart for patient selection and follow-up protocol.
(Notes: CCPMOH = Childhood Cataract Program of the Chinese Ministry of Health; IOL = intraocular lens; OH = ocular hypertension).
Figure 2. Postsurgery time to diagnosis of…
Figure 2. Postsurgery time to diagnosis of OH in children.
OH onset (diagnosis) time after surgery was recorded as months. (OH = ocular hypertension).
Figure 3. The peak IOP value at…
Figure 3. The peak IOP value at the time of OH diagnosis.
The IOP value measured at the time of diagnosis was the highest IOP value in the OH-affected eyes during the study. (Notes: IOP = intraocular pressure; OH = ocular hypertension).
Figure 4. Duration between the appearance (diagnosis)…
Figure 4. Duration between the appearance (diagnosis) and disappearance of ocular hypertension in children.

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