Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark.
Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Acta Ophthalmol. 2024 Sep;102(6):667-673. doi: 10.1111/aos.16636. Epub 2024 Jan 17.
To examine the long-term risk of glaucoma after cataract surgery in childhood.
This study took place from January 2022 until December 2022 and included patients from a large family with hereditary childhood cataract who had cataract surgery before 18 years of age. Patients underwent an ophthalmologic examination to determine the presence of glaucoma or ocular hypertension (OHT). Patients who did not want to participate in the examination could contribute with a medical journal from their treating ophthalmologist. The risk of long-term glaucoma was determined using survival analysis, and risk factors were assessed using a Cox proportional hazards regression model.
We included 68 patients (133 eyes) with a median age at cataract surgery of 7 years (IQR: 5-10). The median follow-up time after cataract surgery to glaucoma/OHT or the latest ophthalmologic examination was 35 years (IQR: 15-48). Twelve patients (18 eyes) had glaucoma, and five patients (eight eyes) had OHT, resulting in 15 patients with glaucoma/OHT. The long-term risk of glaucoma/OHT diagnosed in adulthood was 47.7% (CI: 21.8-70.9) at the age of 70 years of patients who were free of glaucoma before their 18th year. We could not confirm or dismiss an association between glaucoma/OHT and sex, age at surgery, number of ocular interventions before 18 years of age or glaucoma after cataract surgery in a first-degree relative.
Cataract surgery in childhood is associated with a high risk of late-onset glaucoma. Regular lifelong follow-up is important to ensure early diagnosis and prevent extensive vision loss.
探讨儿童期白内障手术后青光眼的长期风险。
本研究于 2022 年 1 月至 2022 年 12 月进行，纳入了来自一个具有遗传性儿童白内障家族的患者，这些患者在 18 岁之前接受了白内障手术。患者接受了眼科检查，以确定是否存在青光眼或眼高压（OHT）。不愿接受检查的患者可以提供其治疗眼科医生的病历。使用生存分析确定长期青光眼的风险，并使用 Cox 比例风险回归模型评估风险因素。
我们纳入了 68 名患者（133 只眼），白内障手术时的中位年龄为 7 岁（IQR：5-10）。白内障手术后至青光眼/OHT或最近一次眼科检查的中位随访时间为 35 年（IQR：15-48）。12 名患者（18 只眼）患有青光眼，5 名患者（8 只眼）患有 OHT，导致 15 名患者患有青光眼/OHT。在 70 岁时，没有在 18 岁之前被诊断为青光眼的患者中，成人期诊断为青光眼/OHT 的长期风险为 47.7%（CI：21.8-70.9）。我们无法确认或排除青光眼/OHT与性别、手术年龄、18 岁之前的眼部干预次数或一级亲属白内障手术后青光眼之间的关联。
儿童期白内障手术与晚期发生青光眼的风险较高相关。定期进行终身随访对于确保早期诊断和预防广泛的视力丧失非常重要。
