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  • Robert Preidt
  • Posted December 22, 2020

Cataract Surgery in Infancy May Raise Glaucoma Risk in Childhood

Infants who have cataract removal surgery are at increased risk for sight-threatening glaucoma later in childhood, researchers say.

Glaucoma damages the optic nerve -- the connection between the eye and brain -- and can lead to vision loss.

Fewer than 2,500 infants are born with a cataract (clouding of the eye's lens) each year in the United States. Surgery is used to remove the affected lens. Some infants receive a lens implant while others go without a lens and use a contact lenses (for one eye) or glasses (for two eyes) to help them focus properly.

This long-term study included 110 children who were born with a cataract in one eye and had the cataract removed when they were aged 1-6 months. They were randomly assigned to receive an artificial lens implant or go without a lens.

Ten years after cataract removal surgery, children in both groups had a 22% risk of glaucoma, according to the U.S. National Eye Institute (NEI)-funded study, published Dec. 17 in the journal JAMA Ophthalmology.

"The results challenge the notion that replacing the child's lens with an implanted one protects the child from developing glaucoma, a belief among some pediatric ophthalmology surgeons," said study principal investigator Dr. Scott Lambert, a professor of ophthalmology at Stanford University in California.

Twenty-five eyes (24%) had developed glaucoma and 21 eyes (20%) had suspected glaucoma due to increased eye pressure.

The lifetime glaucoma risk for patients who have cataract removal as infants isn't known, but this study found that the risk rose from 9% at 1 year, to 17% at 5 years, and to 22% at 10 years.

"These findings underscore the need for long-term glaucoma surveillance among infant cataract surgery patients. They also provide some measure of assurance that it is not necessary to place an intraocular lens at the time of cataract surgery," NEI Director Dr. Michael Chiang said in an institute news release.

"Any child who has had a cataract removed needs to be seen by an eye care provider once a year at a minimum," said study lead author Dr. Sharon Freedman, a pediatric glaucoma specialist at Duke University in Durham, N.C.

"Any child diagnosed with glaucoma or above-normal intraocular pressure without signs of ocular damage -- what we called glaucoma suspect -- should be monitored every four to six months depending upon the stability of the condition and the health of the eye," Freedman said in the release.

More information

The American Academy of Ophthalmology has more on cataracts in children.

SOURCE: U.S. National Eye Institute, news release, Dec. 17, 2020

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