PREVALENCE OF GLAUCOMA AFTER SURGERY FOR PHPV AND INFANTILE CATARACTS

The prevalence of glaucoma associated with pediatric aphakia has been reported to range from 0% to 27%. Few studies have included a signific ant number of patients with persistent hyperplastic primary vitreous ( PHPV) cataracts. The purpose of this study was to evaluate the prevale nce of glaucoma in young children undergoing surgery for PHPV and infa ntile cataracts. The charts of all of the patients who underwent lense ctomy/vitrectomy for infantile and PHPV cataracts at the University of Iowa Hospitals and Clinics between 1975 and 1992 were reviewed. Patie nts with ocular abnormalities that might predispose to glaucoma and pa tients with less than 6 months follow up were excluded. A total of 72 patients (109 eyes) were identified: 25 patients (26 eyes) with PHPV c ataracts and 47 patients (83 eyes) with infantile cataracts. Mean age at time of surgery for both groups was 3.5 months. Mean follow up was 84.5 months for those with PHPV, and 76.9 months for those with infant ile cataracts. Glaucoma developed in eight (32%) of the 25 patients wi th PHPV acid in 15 (32%) of the 47 with infantile cataracts. Mean time to onset of glaucoma was 64.6 months for those with PHPV and 47.5 mon ths for those with infantile cataracts (P=.70). Although there was no significant difference between the prevalence of postoperative glaucom a in those with infantile and those with PHPV cataracts, the prevalenc e of glaucoma in these patients is high. Children with aphakia should be closely monitored for glaucoma throughout their lives.