About My Health Careers Internship MedBlogs Contact us
Cataract Surgery in Infants Might Increase Risk of Glaucoma

Cataract Surgery in Infants Might Increase Risk of Glaucoma

Font : A-A+

  • Cataract surgery in infants may not reduce the risk of glaucoma andposes a 22% risk of developing glaucoma 10 years later
  • Replacing the lens in the infant's eye during surgery may not predict very well the final power of the intraocular lens at a child’s maturity
  • This urges the need for regular eye monitoring in glaucoma suspected infants every four to six months, depending upon their condition

Cataract surgery in infants may not decrease the risk of glaucoma. Despite intraocular lens implants in children, they still have a 22% risk of developing glaucoma 10 years later, as per the National Eye Institute (NEI)-funded Infant Aphakic Treatment Study, published in the journal JAMA Ophthalmology. NEI is part of the National Institutes of Health.

"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," says Michael F. Chiang, M.D., director of NEI.


Cataract Surgery in Infants Might Increase Risk of Glaucoma

This disputes the idea of protection offered by the implanted lens in a child against developing glaucoma. Less than 2,500 children in the U.S. are born with a cataract (clouding of the eye's lens) annually.

Glaucoma is a sight-threatening condition that damages the optic nerve-the connection between the eye and brain.

Cataract surgery is used to remove and replace the cloudy lens. It is speculated that surgery interferes with the maturation of how fluid flows out of the infant's eye that leads to increased eye pressure and optic nerve damage, causing glaucoma.

Patients at Risk for Glaucoma

The team involved 114 study participants (ages 1-6 months) born with a cataract in one eye. In the operating room during cataract removal, the infants were randomly assigned to receive an artificial lens implant or go without a lens, a condition called aphakia.

"I tell patients' parents that implanting a lens in the infant's eye is like buying your child's wedding shoes when they're an infant. It is hard to predict what final power the intraocular lens should have, without knowing how that eye will grow over the years, so placing a lens at the time of cataract removal in an infant involves estimation and may not turn out to be correct. Hence the eye may end up needing strong glasses or even replacement of the original lens implant," says the lead author on the paper, Sharon F. Freedman, M.D., a Pediatric Glaucoma specialist at Duke University, Durham, North Carolina.

Upon re-examination of 110 children at 10 years, 25 eyes (24%) had developed glaucoma, and 21 eyes (20%) were glaucoma suspects due to elevated eye pressure. However, visual acuity was preserved. At 10 years, 40% of the followed children had developed the diagnosis of glaucoma or glaucoma suspect.

Need for Regular Assessment

The evidence of glaucoma-related eye damage - assessed by imaging of the optic nerve head to measure the retinal nerve fiber layer thickness, was not found. This was attributed to the close patient monitoring, as any sign of glaucoma was aggressively treated. The study found that the risk of glaucoma after cataract removal rosefrom 9% at 1 year, to 17% at 5 years, and to 22% at 10 years.

The team thereby urged the need for regular eye monitoring in glaucoma suspected infants every four to six months. Thus, the study highlights the timing of cataract surgery as a balancing act. Whereas surgery at younger ages increases glaucoma risk, delaying surgery boosts the risk of amblyopia, a leading cause of visual impairment in children that results when a cataract in one eye causes the brain to ignore signals from that eye and favor the other eye.

Collaboration among the 12 study centers defined diagnostic standards for pediatric glaucoma and glaucoma suspect and criteria for glaucoma-related adverse events, said Freedman.

  1. Glaucoma-Related Adverse Events at 10 Years in the Infant Aphakia Treatment Study: Sharon F. Freedman et al: JAMA Ophthamology Dec 2020: doi:10.1001/jamaophthalmol.2020.5664

Source: Medindia

News A-Z
News Category
What's New on Medindia
January is the Thyroid Awareness Month in 2022
Menstrual Disorders
Coffee May Help You Fight Endometrial Cancer
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Glaucoma Cataract Cataract in Detail Eye Vision Blindness Facts Double Vision Eye Redness Eye Pain Symptom Evaluation Clear the Blur-Tips to Boost Your Eye-Q 

Recommended Reading
Cataract may Occur in Children Too, Say Doctors
Cataract might strike kids and require a far more complicated treatment, say doctors....
Cataract Blindness to Double by 2020
Vrijesh Desai, a professional photographer diagnosed with cataract was implanted with the extended ....
Quiz On Cataract
Many people are not aware of a common condition affecting the eyes called cataract. This ......
Intraocular Lens Implant (IOL) in Cataract Surgery
An intraocular lens (IOL) is an artificial lens made of silicone or acrylic, placed within the eye ....
A cataract is cloudiness in the crystalline lens of the eye that results in a gradually progressive ...
Cataract in Detail
Encyclopedia section of medindia gives general info about Cataract...
Clear the Blur-Tips to Boost Your Eye-Q
Eye problems may present as blurry vision or simply a minor headache, but they can affect your life ...
Double Vision
Diplopia or double vision is a type of visual impairment in which two images of the same object are ...
Eye Pain Symptom Evaluation
Eye pain usually follows trauma, eye infection or inflammation of the eye and the surrounding struct...
Eye Redness
Redness of the eye occurs due to the dilation of the blood vessels of the eye. It can occur due to e...
Glaucoma is a group of disorders involving the optic nerve, often associated with a rise in intraocu...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2022

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use
open close
I have read and I do accept terms of use - Telemedicine

Advantage Medindia: FREE subscription for 'Personalised Health & Wellness website with consultation' (Value Rs.300/-)