Glaucoma: Long Term Complications of Infantile Aphakia

Abstract

65 children with glaucoma following cataract surgery were studied. Patients with bilateral lensectomy followed by bilateral glaucoma, bilateral lensectomy followed by unilateral glaucoma, and unilateral lens surgery followed by unilateral glaucoma were identified. Vitreous cutting instruments were used for 80% of the lensectomy procedures. 77% of patients were operated in the first year of life, and 87% of patients were recognized to have glaucoma two or more years after their lensectomy. Preoperative gonioscopy revealed no consistent angle abnormality, while postoperative gonioscopy revealed open angles associated with a near constant (96%) but variable abnormality. This angle defect was characterized by blockage of the trabecular meshwork by an acquired anterior repositioning of the iris root over the posterior trabecular meshwork associated with other secondary angle abnormalities.

Surgical treatment of pediatric aphakic glaucoma was most successful with a trabeculectomy or with placement of a glaucoma implant.

• glaucoma
• aphakia
• infantile cataract