Does primary intraocular lens implantation prevent "aphakic" glaucoma in children?

S. Asrani, S. Freedman, V. Hasselblad, E. G. Buckley, J. Egbert, E. Dahan, H. Gimbel, D. Johnson, S. McClatchey, M. Parks, David Plager, E. Maselli

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Abstract

PURPOSE: Open-angle glaucoma may develop after surgery for congenital or developmental cataract with an incidence ranging from 3% to 41%. The pathogenesis of "aphakic" (open-angle) glaucoma remains unknown. Despite numerous reported clinical series (>1000 eyes), we are unaware of any reported case of open-angle glaucoma after primary intraocular lens (IOL) implantation for congenital or developmental cataract. We decided to test the hypothesis that primary posterior chamber IOL implantation might decrease the incidence of open-angle glaucoma in children. METHODS: Pseudophakic eyes were collected from surgeons who contributed data to a refractive study and who monitored intraocular pressure on a regular basis. IOL implantation was commonly performed in eyes with a corneal diameter >10 mm. Comparable primary data on aphakic eyes were included from 2 published studies on aphakic glaucoma, which included corneal diameters and the patient's age at surgery. Glaucoma-free survival estimates for each cohort were estimated. RESULTS: Only 1 case of glaucoma was found among 377 eyes with primary pseudophakia (mean age of patient, 5.1 +/- 4.7 years; mean follow-up, 3.9 +/- 2.7 years). There were 14 eyes (11.3%) with glaucoma among 124 aphakic eyes (mean age of patient, 2.7 +/- 2.6 years; mean follow-up time, 7.2 +/- 3.9 years). CONCLUSIONS: We report a decreased incidence of open-angle glaucoma among eyes rendered primarily pseudophakic compared with those that remained aphakic after cataract surgery. We propose 2 theories on the possible mechanism of reduction in the incidence of glaucoma in pseudophakic eyes.

Original languageEnglish (US)
Pages (from-to)33-39
Number of pages7
JournalJournal of AAPOS
Volume4
Issue number1
StatePublished - Feb 2000

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Intraocular Lens Implantation
Glaucoma
Open Angle Glaucoma
Cataract
Incidence
Pseudophakia
Intraocular Pressure
Survival

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Asrani, S., Freedman, S., Hasselblad, V., Buckley, E. G., Egbert, J., Dahan, E., ... Maselli, E. (2000). Does primary intraocular lens implantation prevent "aphakic" glaucoma in children? Journal of AAPOS, 4(1), 33-39.

Does primary intraocular lens implantation prevent "aphakic" glaucoma in children? / Asrani, S.; Freedman, S.; Hasselblad, V.; Buckley, E. G.; Egbert, J.; Dahan, E.; Gimbel, H.; Johnson, D.; McClatchey, S.; Parks, M.; Plager, David; Maselli, E.

In: Journal of AAPOS, Vol. 4, No. 1, 02.2000, p. 33-39.

Research output: Contribution to journalArticle

Asrani, S, Freedman, S, Hasselblad, V, Buckley, EG, Egbert, J, Dahan, E, Gimbel, H, Johnson, D, McClatchey, S, Parks, M, Plager, D & Maselli, E 2000, 'Does primary intraocular lens implantation prevent "aphakic" glaucoma in children?', Journal of AAPOS, vol. 4, no. 1, pp. 33-39.
Asrani S, Freedman S, Hasselblad V, Buckley EG, Egbert J, Dahan E et al. Does primary intraocular lens implantation prevent "aphakic" glaucoma in children? Journal of AAPOS. 2000 Feb;4(1):33-39.
Asrani, S. ; Freedman, S. ; Hasselblad, V. ; Buckley, E. G. ; Egbert, J. ; Dahan, E. ; Gimbel, H. ; Johnson, D. ; McClatchey, S. ; Parks, M. ; Plager, David ; Maselli, E. / Does primary intraocular lens implantation prevent "aphakic" glaucoma in children?. In: Journal of AAPOS. 2000 ; Vol. 4, No. 1. pp. 33-39.
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AU - Asrani, S.

AU - Freedman, S.

AU - Hasselblad, V.

AU - Buckley, E. G.

AU - Egbert, J.

AU - Dahan, E.

AU - Gimbel, H.

AU - Johnson, D.

AU - McClatchey, S.

AU - Parks, M.

AU - Plager, David

AU - Maselli, E.

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N2 - PURPOSE: Open-angle glaucoma may develop after surgery for congenital or developmental cataract with an incidence ranging from 3% to 41%. The pathogenesis of "aphakic" (open-angle) glaucoma remains unknown. Despite numerous reported clinical series (>1000 eyes), we are unaware of any reported case of open-angle glaucoma after primary intraocular lens (IOL) implantation for congenital or developmental cataract. We decided to test the hypothesis that primary posterior chamber IOL implantation might decrease the incidence of open-angle glaucoma in children. METHODS: Pseudophakic eyes were collected from surgeons who contributed data to a refractive study and who monitored intraocular pressure on a regular basis. IOL implantation was commonly performed in eyes with a corneal diameter >10 mm. Comparable primary data on aphakic eyes were included from 2 published studies on aphakic glaucoma, which included corneal diameters and the patient's age at surgery. Glaucoma-free survival estimates for each cohort were estimated. RESULTS: Only 1 case of glaucoma was found among 377 eyes with primary pseudophakia (mean age of patient, 5.1 +/- 4.7 years; mean follow-up, 3.9 +/- 2.7 years). There were 14 eyes (11.3%) with glaucoma among 124 aphakic eyes (mean age of patient, 2.7 +/- 2.6 years; mean follow-up time, 7.2 +/- 3.9 years). CONCLUSIONS: We report a decreased incidence of open-angle glaucoma among eyes rendered primarily pseudophakic compared with those that remained aphakic after cataract surgery. We propose 2 theories on the possible mechanism of reduction in the incidence of glaucoma in pseudophakic eyes.

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