Glaucoma after pediatric cataract surgery in a population with limited access to care

Craig Baden, Fortunate Shijab, Susan Lewallen, Paul Courtright, Anthony Hall
Publication year: 

Background: Cataract is a leading cause of childhood blindness in eastern Africa and other resource-constrained regions around the world, and high-quality surgical centers are increasingly responding to this challenge. Despite evidence concerning the ongoing risk of postoperative glaucoma after lensectomy, little is known of the incidence of glaucoma after pediatric cataract surgery in Africa. We sought to evaluate the frequency and predictors of postoperative glaucoma in this setting.

Methods: The medical records of all children who underwent surgery for congenital or developmental cataract between 2003 and 2005 at the Kilimanjaro Christian Medical Centre were retrospectively reviewed to determine the incidence of postoperative glaucoma. Potential risk factors were evaluated by means of logistic regression.

Results: Cumulative incidence of glaucoma at 3 years was 6.5% (95% CI, 2.5-16.0), and the annual incidence rate was 2.0 cases per 100 operated eyes (95% confidence interval, 0.74-4.37). Total time of follow-up and absence of primary intraocular lens implantation correlated with risk for postoperative glaucoma, but multivariate analysis could not confirm independent associations.

Conclusions: As cataract surgical rates continue to increase and pediatric ophthalmology centers in Africa progress toward the goals of Vision 2020: The Right to Sight, renewed efforts must be directed toward the long-term postoperative care of all children undergoing operation for pediatric cataract.