A PROSPECTIVE-STUDY OF OCULAR HYPERTENSION AND GLAUCOMA AFTER PEDIATRIC CATARACT-SURGERY

Background: Late-onset glaucoma can occur after pediatric cataract sur gery. However, no large prospective study of the prevalence of ocular hypertension and glaucoma after pediatric cataract surgery has been pe rformed. Methods: A prospective glaucoma evaluation was offered to all eligible subjects at least 5 years after automated lensectomy and vit rectomy for pediatric cataracts. Results: Sixty-two (58%) of 107 eligi ble subjects received a glaucoma evaluation, One (4.5%) of 22 patients with bilateral cataracts had glaucoma, and a much higher percentage ( 45%) had ocular hypertension. Five (12.5%) of 40 patients with unilate ral cataracts had glaucoma, and an additional 32.5% had ocular hyperte nsion. For patients with monocular cataracts, the age and corneal diam eter at the time of cataract surgery were related to the subsequent de velopment of ocular hypertension or glaucoma. The majority of subjects were able to cooperate with a comprehensive glaucoma examination that included cycloplegic refraction, determination of intraocular pressur e, examination of the optic nerve, and fundus photography, without req uiring sedation. Conclusions: There is a high prevalence of ocular hyp ertension after pediatric cataract surgery. Children who are 5 years o f age and older usually are able to cooperate with a glaucoma evaluati on. The natural history of ocular hypertension after pediatric catarac t surgery will be determined with longitudinal studies in the future.