130312 Does secondary intraocular lens implantation increase the risk of glaucoma in aphakic patients who underwent cataract surgery in childhood?
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND/AIMS: Secondary intraocular lens (IOL) implantation is reported to increase glaucoma development and progression in paediatric patients. We evaluated the risk of new-onset glaucoma or progression following secondary IOL implantation in children and young adults. METHODS: Retrospective cohort study of secondary IOL implantation following paediatric cataract surgery at Moorfields Eye Hospital (2017-2025). Anterior chamber IOLs or retinal pathology were excluded. Primary outcome was glaucoma progression (worsening optic disc appearance, sustained intraocular pressure (IOP) elevation requiring medical therapy escalation and/or glaucoma surgery). Secondary outcomes included longitudinal IOP trends and best-corrected visual acuity. RESULTS: 57 eyes were included (30 paediatric, 0-16 years; 27 young adult, 17-30 years); mean follow-up 28.2 months (SD±26.4). Aetiology was congenital (49%), uveitic (26%) and traumatic (25%). IOL position was ciliary sulcus (68%), capsular bag (18%) and scleral-fixated (14%). Glaucoma progression occurred in 16 eyes (28%), predominantly in eyes with pre-existing glaucoma (15/21, 71%), vs 1/36 eyes (3%) without pre-existing glaucoma (relative risk 25.7; 95% CI 3.7 to 181.0; p<0.0001). Progression was most frequent in uveitic eyes (67%) and was not observed in traumatic cataract (p=0.00012). No significant association was observed between age group or IOL position and glaucoma progression. CONCLUSIONS: Secondary IOL implantation is associated with a significant risk of glaucoma progression in eyes with pre-existing glaucoma but appears unlikely to induce new-onset glaucoma in eyes without prior disease. These findings highlight the importance of careful patient selection, counselling and close postoperative surveillance in patients with pre-existing glaucoma undergoing secondary IOL implantation.
Source: British Journal of Ophthalmology
Institution: Moorfields Eye Hospital
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4414848191