Intraocular Lens Implantation as an Isolated Risk Factor for Secondary Glaucoma in Pediatric Patients

Background: Infantile cataract is a significant cause of treatable childhood blindness. Cataract extraction is the treatment of choice to avoid deprivation amblyopia and strabismus. However, the development of secondary glaucoma following cataract surgery among pediatric patients is one of the most serious possible complications. While many cataract surgeries currently include the transplant of intraocular lens (IOL), the effect of this procedure over the risk of glaucoma development hasn’t been assessed yet.

Objective: The assessment of the effect of IOL implantation in pediatric cataract surgeries over the development of secondary glaucoma.

Methods: This was a retrospective cohort study reviewing the medical records of children under the age of 16, who had undergone cataract surgery in the Soroka University Medical Center between 1996 to 2016 for congenital or developmental cataract which included an intraocular lens (IOL) implantation. Patients with known risk factors for glaucoma were excluded from the study.

Results: Of the 255 children below age 16 who were operated, 73 (124 eyes) met inclusion and exclusion criteria. Follow-up ranged from 4 to 18 years. Only one patient (0.8% of the 124 eyes) developed glaucoma in one of his two operated eyes; the surgeries were performed at 10 months, one week apart, and glaucoma was diagnosed 4 months later. One patient had suspected glaucoma in both eyes (incidence of 1.6%). Both children were of Bedouin origin.

Conclusion: IOL implantation, by itself, is not a risk factor for development of secondary glaucoma following cataract surgery in a population below 16 years of age.