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Incidence of Glaucoma-Related Adverse Events in the First 5 Years After Pediatric Lensectomy

2023; American Medical Association; Volume: 141; Issue: 4 Linguagem: Inglês

10.1001/jamaophthalmol.2022.6413

2168-6173

Erick D. Bothun, Michael X. Repka, Raymond T. Kraker, Rui Wu, David A. Leske, Sarah R. Hatt, Zhuokai Li, Sharon F. Freedman, William F. Astle, Susan A. Cotter, Jonathan M. Holmes, David K. Wallace, Laura B. Enyedi, S. Grace Prakalapakorn, Sarah K. Jones, Denise Hug, Erin D. Stahl, Rebecca J. Dent, Lingkun Kong, Serena Wang, Bryan K. Gallerson, Amy K. Hutchinson, Phoebe D. Lenhart, Judy Brower, David G. Morrison, Scott T. Ruark, Rebecca Mets-Halgrimson, Hawke Yoon, Hantamalala Ralay Ranaivo, Aaliyah Hamidullah, Raymond G. Areaux, Jill S. Anderson, Ann M. Holleschau, Rosanne Superstein, Caroline Bélanger, Nicole Fallaha, Patrick Hamel, Maryse Thibeault, Susanna M. Tamkins, Ta Chen Chang, Hee-Jung S. Park, Anya A. Trumler, Xiaonong Liu, Emi Sanders, Elias I. Traboulsi, Fatema F. Ghasia, Diana C. McOwen, Michael E. Gray, Michael B. Yang, Corey S. Bowman, Jennifer Galvin, Margaret Therriault, Heather Smith, Michele E. Whitaker, Faruk Örge, A. Paula Grigorian, Alicia M. Baird, Mitchell B. Strominger, Vicki Chen, Shelley Klein, Jacquelyn D. Kemmer, Alexandra E. Neiman, Myra N. Mendoza, Jill J. Frohwein, Don L. Bremer, Cybil Cassady, Richard P. Golden, Catherine O. Jordan, David L. Rogers, Sara A. Oravec, Tammy L. Yanovitch, Keven Lunsford, Christina Nye, Caroline Shea, SueAnn M. Stillman, Gaétan Laroche, Stephen C. Van Iderstine, Elisa Robertson, Oscar A. Cruz, Rafif Ghadban, Dawn Govreau, Scott A. Larson, Susannah Q. Longmuir, Xiaoyan Shan, Michael W. Clarke, Kate Taylor, Christine Powell, Benjamin P. Hammond, Matthew D. Gearinger, Andrea Czubinski, Dorothy Hendricks, Jing Jin, Jonathan Salvin, Alicia Fisher, Katherine A. Lee, Daniel Brooks, Bonita R. Schweinler, Nicholas A. Sala, Allyson M. Sala, Allison I. Summers, Daniel J. Karr, Lorri B. Wilson, Paula K. Rauch, Mary O’Hara, Nandini Gandhi, Tania Hashmi, Jeffrey Colburn, Eileen Dittman, Charles R. Whitfill, Amy M. Wheeler, Emily A. McCourt, Jasleen Singh, Nanastasia Welnick, Nathalie F. Azar, Joseph Baker, Patrick J. Droste, Robert J. Peters, Jan Hilbrands, Stacy L. Pineles, Marianne J. Bernardo, Edward Peterson, Charla H. Peterson, Kartik Kumar, Ephrem Melese, Robert W. Lingua, Jeff Grijalva, Earl R. Crouch, Earl R. Crouch, Gaylord Ventura, William Anninger, Shawn L. Benson, Karen A. Karp, Jordana M. Smith, Jill Brickman-Kelleher, Benjamin H. Ticho, Alexander J. Khammar, Deborah A. Clausius, Suquin Guo, Donny W. Suh, Carolyn Chamberlain, Susan Schloff, William P. Madigan, Donna Burkman, Stephen P. Christiansen, Jean E. Ramsey, Kate H. McConnell, Ilana Friedman, José Rosado, Donald P. Sauberan, Jody C. Hemberger, Patricia L. Davis, Indre Rudaitis, Robert S. Lowery, Shawn Cupit, Brian G. Mohney, Suzanne M. Wernimont, Rebecca A. Neilsen, Erin P. Herlihy, Francine Baran, Amy Gladstone, Justin Smith, Mei Mellott, Troy Kieser, S. Ayse Erzurum, Beth Colon, Birva Shah, Micaela Quebbemann, Roy W. Beck, Darrell S. Austin, Nicole M. Boyle, Courtney L. Conner, Danielle L. Chandler, Quayleen Donahue, Brooke P. Fimbel, Julianne L. Robinson, Amra Hercinovic, James E. Hoepner, Joseph D. Kaplon, Robert J. Henderson, Michele Melia, Gillaine Ortiz, Victoria C. Woodard, Kathleen M. Stutz, Desirae R. Sutherland, Donald F. Everett, Marie Diener‐West, John D. Baker, Barry R. Davis, Dale L. Phelps, Stephen W. Poff, Richard Saunders, Lawrence Tychsen, Yasmin S. Bradfield, Nicole C. Foster, David A. Plager, Daniel J. Salchow, Eileen E. Birch, Ruth E. Manny, Jayne L. Silver, Katherine K. Weise, Lisa C. Verderber, Trevano W. Dean, Kimberly G. Yen, Alejandra G. de Alba Campomanes, Marielle P. Young, Bahram Rahmani, Kathryn M. Haider, George F. Whitehead, Scott R. Lambert, Sudhi P. Kurup, Courtney L. Kraus,

Ocular Infections and Treatments

Importance Glaucoma can develop following cataract removal in children. Objective To assess the cumulative incidence of glaucoma-related adverse events (defined as glaucoma or glaucoma suspect) and factors associated with risk of these adverse events in the first 5 years after lensectomy prior to 13 years of age. Design, Setting, and Participants This cohort study used longitudinal registry data collected at enrollment and annually for 5 years from 45 institutional and 16 community sites. Participants were children aged 12 years or younger with at least 1 office visit after lensectomy from June 2012 to July 2015. Data were analyzed from February through December 2022. Exposures Usual clinical care after lensectomy. Main Outcomes and Measures The main outcomes were cumulative incidence of glaucoma-related adverse events and baseline factors associated with risk of these adverse events. Results The study included 810 children (1049 eyes); 443 eyes of 321 children (55% female; mean [SD] age, 0.89 [1.97] years) were aphakic after lensectomy, and 606 eyes of 489 children (53% male; mean [SD] age, 5.65 [3.32] years) were pseudophakic. The 5-year cumulative incidence of glaucoma-related adverse events was 29% (95% CI, 25%-34%) in 443 eyes with aphakia and 7% (95% CI, 5%-9%) in 606 eyes with pseudophakia; 7% (95% CI, 5%-10%) of aphakic eyes and 3% (95% CI, 2%-5%) of pseudophakic eyes were diagnosed as glaucoma suspect. Among aphakic eyes, a higher risk for glaucoma-related adverse events was associated with 4 of 8 factors, including age less than 3 months (vs ≥3 months: adjusted hazard ratio [aHR], 2.88; 99% CI, 1.57-5.23), abnormal anterior segment (vs normal: aHR, 2.88; 99% CI, 1.56-5.30), intraoperative complications at time of lensectomy (vs none; aHR, 2.25; 99% CI, 1.04-4.87), and bilaterality (vs unilaterality: aHR, 1.88; 99% CI, 1.02-3.48). Neither of the 2 factors evaluated for pseudophakic eyes, laterality and anterior vitrectomy, were associated with risk of glaucoma-related adverse events. Conclusions and Relevance In this cohort study, glaucoma-related adverse events were common after cataract surgery in children; age less than 3 months at surgery was associated with elevated risk of the adverse events in aphakic eyes. Children with pseudophakia, who were older at surgery, less frequently developed a glaucoma-related adverse event within 5 years of lensectomy. The findings suggest that ongoing monitoring for the development of glaucoma is needed after lensectomy at any age.