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Elgin U, Simsek M, Sen E, Hondur G, Bayraktar S, Acar A. The comparison of corneal densitometry in cases with glaucoma following childhood cataract surgery and juvenile glaucoma. Int Ophthalmol 2024; 44:64. [PMID: 38347316 PMCID: PMC10861629 DOI: 10.1007/s10792-024-03004-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/19/2023] [Indexed: 02/15/2024]
Abstract
PURPOSE To compare the corneal densitometry (CD) in pediatric cases with glaucoma following childhood cataract surgery and juvenile open-angle glaucoma (JOAG). METHODS This prospective comparative study involved 13 eyes with JOAG, 12 eyes with pseudophakic glaucoma, 13 eyes with aphakic glaucoma, and 15 control subjects. Pentacam HR Scheimpflug corneal topography was employed to evaluate corneal thickness (CCT) and CD values. RESULTS The mean intraocular pressure (IOP) and CCT were significantly higher in aphakic glaucoma cases than the other groups (p = 0.001). In aphakic eyes, the mean CD values were higher in most of the anterior, center, and posterior layers of 0-2 mm, 2-6 mm, 6-10 mm, and total zones (p < 0.001 for all). In pseudophakic eyes, the mean CD values were statistically similar with that of aphakic eyes and higher than that of JOAG and control eyes in all layers of 0-2 mm zone and in anterior layer of 10-12 mm and anterior and total layers of 2-6 mm zones (p < 0.05 for all). The CD values demonstrated significant correlations with CCT values in both aphakic and pseudophakic eyes. However, a significant correlation of CD values with IOP was only demonstrated in aphakic eyes (p = 0.01 for all). CONCLUSION The probable effects of childhood cataract surgery especially aphakia might cause corneal backscatter of light and increased CD in all layers in all zones of the cornea. Increased CD values and its correlation with CCT and IOP in aphakic glaucoma eyes may be of importance in clinical management.
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Affiliation(s)
- Ufuk Elgin
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey
| | - Mert Simsek
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey
| | - Emine Sen
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey
| | - Gozde Hondur
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey.
| | - Serdar Bayraktar
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey
| | - Atakan Acar
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey
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Wood KS, Ye E, Trivedi RH, Wilson ME. Preoperative central corneal thickness in eyes with pediatric cataract versus normal fellow eyes. J AAPOS 2023; 27:87.e1-87.e4. [PMID: 36871929 DOI: 10.1016/j.jaapos.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/22/2022] [Accepted: 01/02/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE To compare the preoperative central corneal thickness (CCT) in eyes with unilateral cataract with their normal fellow eyes in the pediatric population. METHODS A retrospective chart review was conducted using the STORM Kids cataract database. Eyes with traumatic cataract, previous surgery or therapeutic manipulation, or age >18 years were excluded. Only eyes with a normal fellow eye were included. The intraocular pressure, age at time of surgery, race, sex, and type of cataract were also extracted from the record. RESULTS A total of 70 eyes with unilateral cataract and 70 fellow normal eyes met inclusion criteria. The mean age at the time of surgery was 3.35 years (range, 0.08-15.05). The mean preoperative CCT in the operated eyes was 577 ± 58 μm (range, 464-898 μm). The mean preoperative CCT in fellow eyes was 570 ± 35 μm (range, 485-643 μm). There was no statistically significant difference between the preoperative CCT in cataract eyes versus unaffected fellow eyes (P = 0.183). When stratified by age, the difference in the CCT between cataract and fellow eyes was greatest in the <1 year age group, but was not statistically significant (P = 0.236). The mean preoperative corneal diameter of operative eyes was 11.0 mm (range, 5.5-12.5 mm [n = 68]). The mean preoperative IOP was 15.1 mm Hg (n = 66). CONCLUSIONS In our study cohort, there was no significant difference in mean preoperative CCT between unilateral pediatric cataract eyes and unaffected fellow eyes.
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Affiliation(s)
- Katherine S Wood
- Medical University of South Carolina, Charleston, South Carolina
| | - Emily Ye
- Medical University of South Carolina, Charleston, South Carolina
| | - Rupal H Trivedi
- Medical University of South Carolina, Charleston, South Carolina
| | - M Edward Wilson
- Medical University of South Carolina, Charleston, South Carolina.
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Chattannavar G, Badakere A, Mohamed A, Kekunnaya R. Visual outcomes and complications in infantile cataract surgery: a real - world scenario. BMJ Open Ophthalmol 2022; 7:e000744. [PMID: 35342821 PMCID: PMC8905877 DOI: 10.1136/bmjophth-2021-000744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 02/04/2022] [Indexed: 11/11/2022] Open
Abstract
Objective To evaluate visual outcomes and complications of infantile cataract surgery through a 1-year follow-up period in a real world scenario. Methods and analysis Prospective observational study evaluating infants with cataract undergoing surgery. Results We analysed 173 eyes of 97 infants (76 bilateral); median age 18.7 weeks, (IQR: 11–33.9 weeks). Toxoplasmosis, rubella, cytomegalovirus and herpes infection was the most common aetiology in both unilateral 10 (47.6%) and bilateral 43 (55.1%) cases, followed by familial and syndromic cases. Fifty-four eyes (29.5%) received primary intraocular lens (IOL) implantation. Seventy-five infants (76%) were less than 6 months of age. At 1-year follow-up, mean log MAR best-corrected visual acuity was 1.00±0.08 and 1.21±0.03 in unilateral and bilateral cases respectively (p=0.012), which was not statistically significant. At 1-year follow-up, pseudophakic(1.09±0.05) eyes had a better mean log MAR visual acuity comparing aphakes(1.24±0.04) clinically but was not statistically significant after the application of Bonferroni correction (p=0.012). The mean myopic shift of −2.9 D±0.39 and −4.53 D±0.55 over 1 year was noted in aphakes and pseudophakes, respectively (p=0.016). Visual axis opacification and glaucoma were the most common complications noted in pseudophakes and aphakes, respectively. Conclusion Primary IOL implantation in selected cases of infantile cataract is a feasible option, particularly in cases when optimal aftercare and refractive rehabilitation of aphakia are not possible.
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Affiliation(s)
- Goura Chattannavar
- Strabimsus, Pediatric and Neuro-ophthalmology, Jasti V Ramanamma Children's Eye care, Child Sight Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Akshay Badakere
- Strabimsus, Pediatric and Neuro-ophthalmology, Jasti V Ramanamma Children's Eye care, Child Sight Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Ashik Mohamed
- Ophthalmic Biophysics, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Ramesh Kekunnaya
- Strabimsus, Pediatric and Neuro-ophthalmology, Jasti V Ramanamma Children's Eye care, Child Sight Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Feizi S, Faramarzi A, Kheiri B. Goldmann applanation tonometer versus ocular response analyzer for measuring intraocular pressure after congenital cataract surgery. Eur J Ophthalmol 2018; 28:582-589. [PMID: 30246567 DOI: 10.1177/1120672118757429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To compare intraocular pressure measured using the Goldmann applanation tonometer with that measured using the ocular response analyzer after congenital cataract surgery. METHODS This study included 113 eyes of 64 patients who underwent lensectomy and vitrectomy. In all, 36 eyes remained aphakic after surgery. Intraocular lens implantation was performed at the time of surgery in 47 eyes and secondarily in 30 eyes. Corneal hysteresis, corneal resistance factor, and cornea-compensated intraocular pressure were measured. The influences of independent factors on the difference between the cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer were investigated using linear regression analyses. Agreement between the two tonometers was investigated using the Bland and Altman and 95% limits of agreement analysis. RESULTS Central corneal thickness, corneal hysteresis, and corneal resistance factor were 591.2 ± 53.3 µm, 10.83 ± 2.27 mmHg, and 11.36 ± 2.14 mmHg, respectively. Cornea-compensated intraocular pressure (16.75 ± 4.82 mmHg) was significantly higher than intraocular pressure measured with Goldmann applanation tonometer (14.41 ± 2.27 mmHg, p < 0.001). Central corneal thickness (p = 0.02) and corneal hysteresis (p < 0.001) were identified as the main predictors of difference between cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer readings. A 95% limits of agreement for cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer was between -4.86 and 9.53 mmHg in the entire group. Cornea-compensated intraocular pressure showed the best agreement with intraocular pressure measured with Goldmann applanation tonometer in the primary pseudophakic subgroup as compared to the other subgroups. CONCLUSION The Goldmann applanation tonometer and ocular response analyzer cannot be used interchangeably for measuring intraocular pressure after congenital cataract surgery. The difference between the cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer was primarily affected by central corneal thickness and corneal hysteresis. Among the subgroups, the primary pseudophakic subgroup had the thinnest cornea and the highest corneal hysteresis values and demonstrated the best agreement between the two tonometers.
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Affiliation(s)
- Sepehr Feizi
- Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Faramarzi
- Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Kheiri
- Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kun L, Szigeti A, Bausz M, Nagy ZZ, Maka E. Preoperative biometry data of eyes with unilateral congenital cataract. J Cataract Refract Surg 2018; 44:1198-1202. [PMID: 30243394 DOI: 10.1016/j.jcrs.2018.06.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 06/19/2018] [Accepted: 06/28/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE To investigate the differences in biometry data of eyes with unilateral congenital cataract and the contralateral normal eyes in pediatric patients. SETTING Pediatric Ophthalmology Division, Ophthalmology Department, Semmelweis University in Budapest, Hungary. DESIGN Retrospective case series. METHODS Data of visually significant unilateral congenital cataract patients who had cataract surgery in the ophthalmology department at Semmelweis University between 2013 and 2016 were collected. At the time of the examinations, the mean age of the patients was 36.4 weeks ± 25.3 (SD). Central corneal thickness (CCT), corneal refractive power (keratometry [K]), horizontal corneal diameter, and axial length (AL) measurement data were obtained from both eyes of each patient. The measurements were taken under general anesthesia using a handheld kerato-refractometer (Retinomax K-plus 3) and an ultrasound instrument (Ocuscan RxP) with contact applanation method and Castroviejo straight-tip calipers at the beginning of the cataract surgery. For statistical evaluation, Originlab 7.0 software was used; paired t tests were performed for the difference analysis between the 2 sides. RESULTS Forty-two infants (50% girls) were included. In the cases of eyes with unilateral congenital cataract, a greater CCT (P = .01330), higher average K (P = .00243), and smaller corneal diameter (P = .00010) were found, although there was no significant difference in AL when compared with the unaffected contralateral eyes. CONCLUSION The data showed that biometric characteristics of the eyes with unilateral congenital cataract differ from the opposite normal eye before the cataract surgery. It is essential to use this biometric data in intraocular lens power calculation and to take them into account in long-term care when screening for secondary glaucoma.
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Affiliation(s)
- Lidia Kun
- From the Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
| | - Andrea Szigeti
- From the Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Maria Bausz
- From the Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Zoltan Zsolt Nagy
- From the Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Erika Maka
- From the Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Abstract
PURPOSE To study the central corneal thickness (CCT) in eyes with microcornea and aphakia and without glaucoma, compare it with normal controls, and correlate it with the measured intraocular pressure (IOP). METHODS The study was conducted on 62 eyes of 31 aphakic children with microcornea. Controls (20 children) were selected from age-matched children presenting for routine refraction. Detailed anterior-segment and fundus examinations were conducted. The CCT and the axial length were measured. Medical records of the study patients were reviewed for the stability of the ocular parameters over time to exclude glaucoma. RESULTS The mean±SD age of the study patients and controls were 4.0 (±3.1, 1.0 to 12.0) and 3.1 (±2.7, 0.6 to 12.0) years, respectively. The mean±SD CCT, the corneal diameter, the measured IOP, the cup/disc ratio, and the axial length of the study patients and the controls were 667.01±72.90 μm, 8.9±0.8 mm, 10.9±5.7 mm Hg, 0.1±0.1, 20.35±2.90 mm and 545.22±28.14 μm, 11.7±0.5 mm, 5.3±1.8 mm Hg, 0.1±0.1, and N/A, respectively. The difference between the study eyes and the controls in the CCT and the measured IOP was statistically significant (P<0.05). CONCLUSIONS Aphakic eyes with microcornea have thicker CCTs and greater measured IOPs than normal eyes. Hence, the measurement of CCT is recommended in the assessment of aphakic eyes with microcornea for possible glaucoma. The measured IOP, although a reliable parameter, in isolation does not provide a diagnosis of glaucoma and must be viewed in conjunction with other patient findings, such as the cup/disc ratio, the progression of which over time must be considered for a more solid diagnosis.
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Central corneal thickness and intraocular pressure changes after congenital cataract surgery with intraocular lens implantation in children younger than 2 years. J Cataract Refract Surg 2017; 43:662-666. [DOI: 10.1016/j.jcrs.2017.02.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 01/27/2017] [Accepted: 02/05/2017] [Indexed: 11/22/2022]
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Faramarzi A, Feizi S, Maghsoodlou A. Factors influencing intraocular pressure, corneal thickness and corneal biomechanics after congenital cataract surgery. Br J Ophthalmol 2017; 101:1493-1499. [DOI: 10.1136/bjophthalmol-2016-310077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/17/2017] [Accepted: 02/28/2017] [Indexed: 11/03/2022]
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Association of Birth Parameters With Corneal Thickness in Prematurely Born and Full-Term School-Aged Children. Cornea 2016; 35:634-7. [PMID: 26967109 DOI: 10.1097/ico.0000000000000789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The objective of this study was to investigate and compare corneal thicknesses of prematurely born and full-term early school-aged children, who were grouped into birth weight categories according to gestational age. METHODS This cross-sectional study included 136 school-aged white children. They were grouped as premature (born before 37 weeks of gestation) and full term (born at or after 37 weeks of gestation). These 2 groups were further divided into birth weight groups according to gestational age as small, appropriate, and large for gestational age. Central corneal thickness (CCT) was measured by ultrasound pachymetry. The intraocular pressures of both groups were measured by a Goldmann applanation tonometer. RESULTS The study included right eyes of 136 children. There were 53 girls and 83 boys whose mean age was 6.5 ± 0.9 years (range: 5-8 yrs). Mean pachymetry of the small for gestational age group (526.8 ± 37.9 μm) in prematurely born children was significantly lower than that of appropriate for gestational age (554.6 ± 34.2 μm) (P = 0.039, mean difference 27.8, 95% confidence interval, 1.1-54.5). When prematurely born and full-term children are compared, the mean pachymetric values of the term children (574.5 ± 37.8 μm) were found to be significantly higher than those of the prematurely born children (545.4 ± 35.6 μm) (P ≤ 0.001). CONCLUSIONS Birth parameters affect CCT in early school-aged children. Prematurely born, small for gestational age children have lesser CCT. This should be kept in mind at their follow-ups.
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Lin D, Chen J, Liu Z, Wu X, Long E, Luo L, Lin Z, Li X, Zhang L, Chen H, Liu J, Chen W, Lin H, Liu Y. Prevalence of Corneal Astigmatism and Anterior Segmental Biometry Characteristics Before Surgery in Chinese Congenital Cataract Patients. Sci Rep 2016; 6:22092. [PMID: 26912400 PMCID: PMC4766530 DOI: 10.1038/srep22092] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/05/2016] [Indexed: 11/12/2022] Open
Abstract
The prevalence and the distribution characteristics of corneal astigmatism (CA) and anterior segment biometry before surgery in Chinese congenital cataract (CC) patients are not completely understood. This study involved 400 CC patients from the Zhongshan Ophthalmic Center enrolled from February 2011 to August 2015. Data on CA, keratometry, central corneal thickness (CCT) and anterior chamber depth (ACD) were measured by the Pentacam Scheimpflug System. The mean age of patients was 54.27 months, and the ratio of boys to girls was 1.53:1. The mean CA was 2.03 diopters (D), and 39.25% of subjects had CA values ≥2 D. The most frequent (71.8%) diagnosis was with-the-rule astigmatism. Oblique astigmatism was present in 16.2% of cases, and 12% of cases had against-the-rule astigmatism. The mean keratometry measurement of cataractous eyes in bilateral patients was significantly larger than that in unilateral patients. Girls had a larger mean keratometry but a thinner CCT than did boys. The CA, CCT, and ACD of cataractous eyes were significantly larger than those of non-cataractous eyes in unilateral patients. The CA, mean keratometry, CCT, and ACD in CC patients varied with age, gender, and laterality. Fully understanding these characteristics may help inform guidelines and treatment decisions in CC patients.
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Affiliation(s)
- Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Jingjing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Erping Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Zhuoling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xiaoyan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Li Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Hui Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Jinchao Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
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Mendez-Hernandez C, Arcos-Villegas G, Garcia-Sanchez J, Garcia-Feijoo J. Clinical classification and medical treatment options in childhood glaucoma. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2015; 90:557-561. [PMID: 26358844 DOI: 10.1016/j.oftal.2015.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 04/10/2015] [Accepted: 07/01/2015] [Indexed: 06/05/2023]
Affiliation(s)
- C Mendez-Hernandez
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clinico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, España; Red Temática de Investigación Cooperativa en Oftalmología (RETICS), Instituto de Salud Carlos III, Madrid, España.
| | - G Arcos-Villegas
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clinico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, España
| | - J Garcia-Sanchez
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clinico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, España; Red Temática de Investigación Cooperativa en Oftalmología (RETICS), Instituto de Salud Carlos III, Madrid, España
| | - J Garcia-Feijoo
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clinico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, España; Red Temática de Investigación Cooperativa en Oftalmología (RETICS), Instituto de Salud Carlos III, Madrid, España
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Bayoumi NHL. Surgical Management of Glaucoma After Congenital Cataract Surgery. J Pediatr Ophthalmol Strabismus 2015; 52:213-20. [PMID: 25915009 DOI: 10.3928/01913913-20150414-11] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/15/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE Cataract surgery in children is a difficult entity with possible complications, glaucoma being particularly common. The purpose of this study was to explore the results of surgical intervention for glaucoma after congenital cataract surgery in Alexandria University, Egypt. METHODS The study was a retrospective chart review of 32 children with glaucoma after congenital cataract surgery between 2005 and 2012. Preoperative, operative, and postoperative data were collected. Complications were noted. Success was studied at the end of follow-up. RESULTS The study included 41 (36 aphakic, 5 pseudophakic) eyes of 32 children undergoing 57 glaucoma surgical procedures. The mean ± standard deviation age at the time of surgery was 17.2 ± 21.6 months (range: 3.0 to 103.5 months) and the mean follow-up period was 39.1 ± 25.2 months (range: 1 to 75 months). The most common (78%) primary glaucoma surgical procedure was combined trabeculotomy-trabeculectomy with mitomycin C. The mean preoperative intraocular pressure, corneal diameter and thickness, cup-disc ratio, and axial length of the study eyes was 22.3 ± 6.1 mm Hg (range: 10 to 34 mm Hg), 11.4 ± 0.9 mm (range: 10 to 13 mm) and 617.6 ± 66.8 µm (range: 538 to 758 µm), 0.5 ± 0.3 mm (range: 0 to 1 mm), and 22.85 ± 2.75 mm (range: 18.55 to 29.17 mm), respectively, and postoperatively at last follow-up was 11.0 ± 7.3 mm Hg (range: 1 to 36 mm Hg), 11.5 ± 0.9 mm (range: 10 to 13 mm) and 576.8 ± 83.3 µm (range: 461 to 736 µm), 0.4 ± 0.3 mm (range: 0 to 1 mm), and 24.62 ± 2.81 mm (range: 19.70 to 32.81 mm), respectively. Success was reported in 34 (82.9%) eyes. Complications included endophthalmitis, hypotony disc edema, and retinal detachment. CONCLUSIONS Glaucoma after congenital cataract surgery is a difficult entity, often requiring more than one surgical procedure to control it. Long-term follow-up is mandatory to detect any failure of treatment at any time point and manage accordingly.
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Gunay M, Celik G, Gunay BO, Dogru M, Gursoy T, Ovali HF. Central corneal thickness measurements in premature infants. Int J Ophthalmol 2014; 7:496-500. [PMID: 24967198 DOI: 10.3980/j.issn.2222-3959.2014.03.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 01/10/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the central corneal thickness (CCT) measurements of premature infants. METHODS The premature infants who were born between 25-34wk of gestational age (GA) were retrieved for the study. All CCT measurements were performed within the first 2d of their life under topical anesthesia by using an ultrasonic pachymeter. RESULTS The mean CCT of 200 eyes was 647.79±63.94 µm. The mean CCT of the right and left eyes were similar (647.30±64.72 µm and 648.29±63.47 µm consecutively). The mean CCT of the girls was 642.08±54.89 µm and the boys was 653.07±71.14 µm, with no statistically significant difference (P>0.05). But there was a negative correlation of the CCT with GA and birth weight (BW) (P<0.01). CONCLUSION The CCT values of premature babies were negatively correlated with GA and BW.
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Affiliation(s)
- Murat Gunay
- Department of Ophthalmology, Zeynep Kamil Women and Childrens' Diseases Education and Research Hospital, Istanbul 34668, Turkey
| | - Gokhan Celik
- Department of Ophthalmology, Zeynep Kamil Women and Childrens' Diseases Education and Research Hospital, Istanbul 34668, Turkey
| | - Betul Onal Gunay
- Department of Ophthalmology, Umraniye Education and Research Hospital, Istanbul 34764, Turkey
| | - Mahmut Dogru
- Department of Pediatrics, Zeynep Kamil Women and Childrens' Diseases Education and Research Hospital, Istanbul 34668, Turkey
| | - Tugba Gursoy
- Department of Neonatology, Zeynep Kamil Women and Childrens' Diseases Education and Research Hospital, Istanbul 34668, Turkey
| | - Husnu Fahri Ovali
- Department of Neonatology, Zeynep Kamil Women and Childrens' Diseases Education and Research Hospital, Istanbul 34668, Turkey
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Ventura MC, Ventura BV, Ventura CV, Ventura LO, Arantes TE, Nosé W. Outcomes of congenital cataract surgery: intraoperative intracameral triamcinolone injection versus postoperative oral prednisolone. J Cataract Refract Surg 2014; 40:601-8. [PMID: 24530023 DOI: 10.1016/j.jcrs.2013.09.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 09/02/2013] [Accepted: 09/08/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare the outcomes of congenital cataract surgery using intraoperative intracameral triamcinolone versus postoperative oral prednisolone to modulate ocular inflammation. SETTING Department of Congenital Cataract, Altino Ventura Foundation, Recife, Brazil. DESIGN Randomized clinical trial. METHODS Children younger than 2 years were randomly divided into 2 groups. The study group received an intraoperative intracameral injection of 1.2 mg/0.03 mL of triamcinolone acetonide. The control group (29 eyes) received 1 mg/kg per day of prednisolone syrup for 15 days postoperatively, which was then tapered over the following 2 weeks. Intraocular pressure (IOP), central corneal thickness (CCT), cell deposits on the intraocular lens (IOL), posterior synechiae, visual axis obscuration, additional surgical procedures, and IOL centration were assessed 12 months postoperatively. RESULTS The mean patient age at surgery was 10.45 months±6.22 (SD) in the study group (31 eyes) and 10.0±6.15 months in the control group (29 eyes) (P=.779). In both groups, the mean IOP and CCT did not change significantly postoperatively (study group P=.922 and P=.149, respectively; control group P=.483 and P=.416, respectively). The groups had similar incidences of cell deposits (P=.517) and posterior synechiae (P=.247). No eye developed visual axis obscuration or had additional surgical procedures. All eyes had a clinically centered IOL. CONCLUSION One year postoperatively, the outcomes were similar with intraoperative intracameral triamcinolone injection and postoperative oral prednisolone for modulating inflammation after congenital cataract surgery. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Marcelo C Ventura
- From the Department of Congenital Cataract (M.C. Ventura, B.V. Ventura, C.V. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Altino Ventura Foundation, and the Department of Congenital Cataract (M.C. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Pernambuco Eye Hospital, Recife; the Department of Ophthalmology (Nosé), Federal University of São Paulo, São Paulo, Brazil.
| | - Bruna V Ventura
- From the Department of Congenital Cataract (M.C. Ventura, B.V. Ventura, C.V. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Altino Ventura Foundation, and the Department of Congenital Cataract (M.C. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Pernambuco Eye Hospital, Recife; the Department of Ophthalmology (Nosé), Federal University of São Paulo, São Paulo, Brazil
| | - Camila V Ventura
- From the Department of Congenital Cataract (M.C. Ventura, B.V. Ventura, C.V. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Altino Ventura Foundation, and the Department of Congenital Cataract (M.C. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Pernambuco Eye Hospital, Recife; the Department of Ophthalmology (Nosé), Federal University of São Paulo, São Paulo, Brazil
| | - Liana O Ventura
- From the Department of Congenital Cataract (M.C. Ventura, B.V. Ventura, C.V. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Altino Ventura Foundation, and the Department of Congenital Cataract (M.C. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Pernambuco Eye Hospital, Recife; the Department of Ophthalmology (Nosé), Federal University of São Paulo, São Paulo, Brazil
| | - Tiago E Arantes
- From the Department of Congenital Cataract (M.C. Ventura, B.V. Ventura, C.V. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Altino Ventura Foundation, and the Department of Congenital Cataract (M.C. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Pernambuco Eye Hospital, Recife; the Department of Ophthalmology (Nosé), Federal University of São Paulo, São Paulo, Brazil
| | - Walton Nosé
- From the Department of Congenital Cataract (M.C. Ventura, B.V. Ventura, C.V. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Altino Ventura Foundation, and the Department of Congenital Cataract (M.C. Ventura), Department of Pediatric Ophthalmology and Strabismus (L.O. Ventura), and Department of Uveitis (Arantes), Pernambuco Eye Hospital, Recife; the Department of Ophthalmology (Nosé), Federal University of São Paulo, São Paulo, Brazil
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Lambert SR, Purohit A, Superak HM, Lynn MJ, Beck AD. Long-term risk of glaucoma after congenital cataract surgery. Am J Ophthalmol 2013; 156:355-361.e2. [PMID: 23639132 PMCID: PMC3720778 DOI: 10.1016/j.ajo.2013.03.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 03/11/2013] [Accepted: 03/12/2013] [Indexed: 11/17/2022]
Abstract
PURPOSE To report the long-term risk of glaucoma development in children following congenital cataract surgery. DESIGN Retrospective interventional consecutive case series. METHODS We retrospectively reviewed the records of 62 eyes of 37 children who underwent congenital cataract surgery when <7 months of age by the same surgeon using a limbal approach. The Kaplan-Meier method was used to calculate the probability of an eye's developing glaucoma and/or becoming a glaucoma suspect over time. RESULTS The median age of surgery was 2.0 months and the median follow-up after cataract surgery was 7.9 years (range, 3.2-23.5 years). Nine eyes (14.5%) developed glaucoma a median of 4.3 months after cataract surgery and an additional 16 eyes (25.8%) were diagnosed as glaucoma suspects a median of 8.0 years after cataract surgery. The probability of an eye's developing glaucoma was estimated to be 19.5% (95% CI: 10.0%-36.1%) by 10 years after congenital cataract surgery. When the probability of glaucoma and glaucoma suspect were combined, the risk increased to 63.0% (95% CI: 43.6%-82.3%). CONCLUSIONS Long-term monitoring of eyes after congenital cataract surgery is important because we estimate that nearly two thirds of these eyes will develop glaucoma or become glaucoma suspects by 10 years after cataract surgery.
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Affiliation(s)
- Scott R Lambert
- Department of Ophthalmology, Emory University, Atlanta, GA 30322, USA.
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Zafar SN, Siddiqui SN, Khan A. Effects of Artisan aphakic intraocular lens on central corneal thickness and intra ocular pressure in pediatric eyes with crystalline subluxated lenses. Oman J Ophthalmol 2013; 6:44-7. [PMID: 23772125 PMCID: PMC3678197 DOI: 10.4103/0974-620x.111914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To study effects of Artisan iris fixated intraocular lens (IOL) on central corneal thickness (CCT) and intraocular pressure (IOP) in pediatric eyes with crystalline subluxated lenses. MATERIALS AND METHODS The study included 17 eyes undergoing Artisan aphakic IOL implantation after lensectomy for subluxated crystalline lenses. CCT and IOP measurements were recorded pre-operatively and post-operatively taking the mean of 4 post-operative visits. Patients were divided into Group A (n = 8) including patients with lensectomy and iris fixation of Artisan IOL as a primary procedure and Group B (n = 9) including patients in which lensectomy was carried out as a primary surgery and Artisan IOL fixation as a secondary procedure. RESULTS Children ranged in age from 08 years to 16 years, mean 11.59 ± 2.96 years. Follow-up period ranged from 7 months to 16 months, mean 11.24 months ± 4.27. Mean pre-operative and post-operative IOP in Group A was 14.88 ± 2.80 and 14.16 ± 0.59 respectively (P = 0.528). In Group B it was 12.44 ± 2.79 and 14.44 ± 1.15 respectively (P = 0.080). Mean pre-operative and post-operative CCT in Group A was 529.13 ± 24.23 and 529.87 ± 17.46 respectively (P = 0.674). In Group B it was 567.33 ± 29.13 and 568.83 ± 25.69 respectively (P = 0.859). CONCLUSIONS Primary and secondary Artisan aphakic IOL implantation did not cause any significant changes in corneal thickness or IOP during the follow-up period.
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Affiliation(s)
- Saemah Nuzhat Zafar
- Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
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Ruddle JB, Staffieri SE, Crowston JG, Sherwin JC, Mackey DA. Incidence and predictors of glaucoma following surgery for congenital cataract in the first year of life in Victoria, Australia. Clin Exp Ophthalmol 2013; 41:653-61. [PMID: 23332011 DOI: 10.1111/ceo.12067] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 01/03/2013] [Indexed: 11/30/2022]
Abstract
AIM To determine the incidence and predictors of glaucoma following surgery for congenital and infantile cataract in an Australian population. DESIGN Retrospective cohort study. PARTICIPANTS Infants (<12 months) having had lens extraction between January 1992 and May 2006, from two tertiary referral centres. METHODS Children with uveitis, anterior segment dysgenesis, aniridia, retinopathy of prematurity, and lens subluxation were excluded. Potential predictors of incident glaucoma were examined using Cox proportional hazards regression with adjustment for clustering between eyes. MAIN OUTCOME MEASURES Incidence and predictors of secondary glaucoma. RESULTS One hundred and forty-seven eyes of 101 patients (46 bilateral cataract; 55 unilateral cataract) were included, with median follow-up of 9.9 years (range 1.2-18.9 years). Cumulative incidence of glaucoma was 32.0% for eyes (n = 47) and 30.7% (n = 31) for subjects. Incidence was higher in children with bilateral cataract (38.9 vs. 17.1%, p = 0.004). There were 3.9 cases of glaucoma per 100 person years of follow-up, the incidence rate being highest for surgery performed in the first month of life. Children with glaucoma had longer median follow-up (11.8 vs. 9.3 years, p = 0.005). Risk of glaucoma decreased with increasing months of age at operation: hazard ratio 0.79, 95% confidence interval 0.69-0.91, p = 0.001. Median visual acuity was worse in children with unilateral cataract (p < 0.001). CONCLUSIONS We identified an increased risk of glaucoma when cataract surgery was performed in younger infants, and in those with bilateral cataract. As glaucoma may develop over a decade following lens extraction, life-long surveillance is needed to prevent glaucoma-associated vision loss.
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Affiliation(s)
- Jonathan B Ruddle
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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Ventura MC, Ventura BV, Ventura CV, Ventura LO, Nosé W. Congenital cataract surgery with intracameral triamcinolone: pre- and postoperative central corneal thickness and intraocular pressure. J AAPOS 2012; 16:441-4. [PMID: 23084381 DOI: 10.1016/j.jaapos.2012.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 06/10/2012] [Accepted: 06/18/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE To evaluate the change in intraocular pressure (IOP) and central corneal thickness (CCT) of children who underwent congenital cataract surgery with injection of triamcinolone acetonide into the anterior chamber at the end of the procedure. METHODS Fifty-three eyes of 34 children <2 years of age who underwent congenital cataract surgery with injection of 1.2 mg/0.03 mL of preservative-free triamcinolone acetonide into the anterior chamber at the end of the procedure were included in this study. IOP and CCT were measured preoperatively and at a mean of 2 and 12 months' follow-up. RESULTS The mean IOP was 8.7 ± 0.4 mm Hg preoperatively, 8.4 ± 0.6 mm Hg at the 2-month follow-up, and 8.1 ± 0.3 mm Hg at the 12-month follow-up. The mean CCT was 562 ± 11 μm preoperatively, 563 ± 10 μm at the 2-month follow-up, and 570 ± 10 μm at the 12-month follow-up. There was no significant change in either pre- or postoperative IOP (P = 0.700) or CCT (P = 0.419) over the study period. CONCLUSIONS Injection of 1.2 mg triamcinolone acetonide at the end of congenital cataract surgery in children <2 years of age did not significantly affect IOP or CCT in the first year after surgery.
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Abstract
Modern surgical techniques allow congenital cataract surgery to be performed much more successfully. The development of a secondary glaucoma is the most dreaded postoperative complication (one third of all pediatric secondary glaucomas). Due to the limited value of the available literature, data on prevalence are unreliable. A 10-year postoperative incidence of 10-25% is given in the literature for developing secondary glaucoma and the frequency increases with the duration of follow-up. A major risk factor seems to be the age at the time of surgery. The younger the patient is at the time of surgery the higher the risk of secondary glaucoma. A microcornea seems to be another risk factor in multivariate analysis. The following postoperative changes might be involved in the pathogenesis: peripheral anterior synechia, high iris insertion and membranous material over the trabecular meshwork. Additionally postoperative inflammation, reaction to lens epithelial cells, perioperative barotrauma and loss of anterior segment architecture might also be responsible. In order to evaluate the optimal age window for congenital cataract surgery and risk factors for the development of secondary glaucoma, a prospective longitudinal study is mandatory.
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Saltzmann RM, Weakley DR, Aggarwal NK, Whitson JT. Glaucoma following infantile cataract surgery. J Pediatr Ophthalmol Strabismus 2011; 48:142-9. [PMID: 21598876 DOI: 10.3928/01913913-20100618-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To examine incidence, risk factors, and outcomes of glaucoma following infantile cataract extraction. METHODS A retrospective chart review of all patients who underwent cataract extraction between January 1, 1993, and December 31, 2006, at the Children's Medical Center in Dallas. RESULTS Sixty-four eyes met inclusion criteria, of which 11 eyes (17.2%) developed glaucoma during a mean follow-up of 65.1 ± 4.3 months. Age younger than 3 months at cataract diagnosis (odds ratio 4.89, P = .05) or cataract extraction (odds ratio 4.4, P = .047) and the presence of anterior chamber anomalies (odds ratio 8.0, P = .01) were the only risk factors found to have statistical significance for the development of glaucoma. Eight of 11 eyes with glaucoma (72.2%) required at least one surgical intervention. Three of 10 eyes (30%) had a final best-corrected visual acuity below 20/400 and another 4 eyes (40%) demonstrated some degree of amblyopia. CONCLUSION Despite modern microsurgical techniques, infantile cataract surgery continues to pose a risk of secondary glaucoma. This was particularly true when cataract was diagnosed and/or extracted in patients younger than 3 months of age. Most eyes that developed glaucoma required surgical management and visual outcomes continue to be poor in this group.
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Affiliation(s)
- Robert M Saltzmann
- University of Texas Southwestern Medical Center, Dallas, TX 75390-9057, USA
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Lopez JP, Freedman SF, Muir K, Duncan L, Stephens D, Atenafu E, Levin AV. Central corneal thickness in children and adolescents with pediatric glaucoma and eye disorders at risk of developing glaucoma. J Pediatr Ophthalmol Strabismus 2011; 48:108-16. [PMID: 20506965 DOI: 10.3928/01913913-20100518-03] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Accepted: 02/24/2010] [Indexed: 12/25/2022]
Abstract
BACKGROUND To investigate central corneal thickness (CCT) in children with glaucoma and at risk for glaucoma. METHODS The study included 139 children with glaucoma: 66 at risk for glaucoma (ie, aphakia, aniridia, or uveitis) and 66 normal children. CCT was measured by ultrasound pachymetry and intraocular pressure (IOP) by applanation. Analysis of variance was used to compare CCT between groups. Correlation analysis assessed associations between CCT and ocular factors including spherical equivalent, cup-to-disc ratio, glaucoma medications, and number of intraocular surgeries. RESULTS CCT was significantly higher for 141 eyes with glaucoma (mean: 0.598 mm, P < .001) and 76 eyes at risk for glaucoma (mean: 0.604 mm, P = .001) than for 66 normal eyes (mean: 0.558 mm). No significant difference was observed between at-risk (P = .989) and glaucoma eyes. Eyes with aphakia (0.653 mm) and aniridia (0.639 mm) had the thickest CCT values. Thinnest CCT was found in anterior segment dysgenesis and uveitis (mean: 0.541 mm). A significant positive correlation between CCT and spherical equivalent was found for glaucoma (r = 0.413; P < .001) and at-risk (r = 0.412; P < .0003) eyes, and between CCT and intraocular surgery for at-risk eyes (P = .0066). A significant negative correlation was found between CCT and cup-to-disc ratio for glaucoma eyes (r = -0.223; P = .01). CONCLUSION This is the largest series of CCT in pediatric glaucoma and related disorders. The data suggest caution in application of standard formulas for IOP-to-CCT correction when evaluating children with glaucoma because their mean CCT values extend far beyond values reported for normal eyes.
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Affiliation(s)
- Juan P Lopez
- Departments of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Acquired central corneal thickness increase following removal of childhood cataracts. Am J Ophthalmol 2011; 151:434-41.e1. [PMID: 21236412 DOI: 10.1016/j.ajo.2010.09.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 09/16/2010] [Accepted: 09/18/2010] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate central corneal thickness (CCT) in children with congenital/developmental cataracts before and after cataract removal, to correlate CCT with corneal diameters before cataract surgery in this same group, and to evaluate CCT over time in a separate group of children who were already aphakic or pseudophakic at study entry. DESIGN Longitudinal study. METHODS Children with cataract (Group 1, with pre-cataract-removal CCT) and aphakia/pseudophakia (Group 2, presenting after cataract removal) were included. CCT measurements were performed using ultrasound pachymetry. Normal fellow eyes of unilaterally affected cases served as controls. In bilateral cases, right eyes were used for analyses. RESULTS Group 1 comprised 66 children. Before cataract surgery, unilateral cases (n = 31) showed similar CCT and strong association between the affected and fellow eyes (552.0 ± 32.9 μm vs 550.9 ± 40.4 μm, respectively; r(2) = 0.71, P = .0001). After cataract surgery, affected eyes (n = 13) showed mean CCT increase of 29.7 ± 43.1 μm (P = .03) while fellow eyes remained unchanged. Similarly, before cataract surgery, bilateral cases (n = 35) showed similar CCT between the right and left eyes. After cataract surgery, mean CCT increase was 27.4 ± 39.4 μm for first operated eyes of bilateral cases (n = 17, P = .01). Group 2 comprised 50 aphakic/pseudophakic children lacking pre-cataract-removal CCT. CCT was higher in eyes with glaucoma vs those without, at both first and last measurements (ΔCCT 58.9 ± 27.0 μm at first examination, P = .034, and 56.4 ± 27.1 μm at last examination, P = .043, respectively). There was no statistically significant CCT change over the study interval (median 28 months) for either Group 2 eyes with or those without glaucoma. CONCLUSIONS CCT in children with cataracts increases after cataract surgery while the fellow eye remains stable. This increase seems to occur early after surgery, likely remaining stable thereafter, though glaucoma can accentuate the increase.
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Xiao W, Liang XF, Sun JJ. Changes of corneal central thickness of aphakia following congenital cataract surgery under the first six months of life. Int J Ophthalmol 2011; 4:78-80. [PMID: 22553615 DOI: 10.3980/j.issn.2222-3959.2011.01.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Accepted: 01/28/2011] [Indexed: 11/02/2022] Open
Abstract
AIM To observe the central corneal thickness (CCT) changes in infants and young children who had been undergone bilateral congenital cataract surgery, and to compare the changes with normal control group which was selected from healthy population. METHODS A cross section case-control study contained 28 cases (56 eyes) of bilateral aphakia (aphakic group) due to congenital cataract surgery combining with posterior continuous curvilinear capsulorhexis and with anterior vitrectomy during 2-6 months after birth. Fourteen children (28 eyes) of age-sex matched with the aphalic group were selected as normal control group. CCT and intraocular pressure (IOP) were measured postoperatively and the results were compared between groups. RESULTS The mean CCT was 653.5±82.4μm in the aphakic group and 579.6±39.2μm in the control group, with a significant difference (P=0.000). The mean value of IOP in aphakic group (22.0±1.6mmHg) was greater than that of control group (16.9±2.1mmHg), P=0.023. There was a negative correlation between age and CCT in normal control group (r=-0.531, P=0.026), and there was no correlation in bilateral aphakia group (r=-0.324, P=0.165) CONCLUSION Aphakic children due to congenital cataract surgery have a greater CCT than normal children. It is necessary to consider CCT in evaluating IOP for children after congenital cataract surgery.
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Affiliation(s)
- Wei Xiao
- Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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Faramarzi A, Javadi MA, Jabbarpoor Bonyadi MH, Yaseri M. Changes in central corneal thickness after congenital cataract surgery. J Cataract Refract Surg 2010; 36:2041-7. [DOI: 10.1016/j.jcrs.2010.07.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 07/06/2010] [Accepted: 07/10/2010] [Indexed: 11/30/2022]
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Central Corneal Thickness in Microphthalmic Eyes with or without History of Congenital Cataract Surgery. Eur J Ophthalmol 2010; 21:374-8. [DOI: 10.5301/ejo.2010.6090] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2010] [Indexed: 12/14/2022]
Abstract
Purpose TO determine the central corneal thickness (CCT) in microphthalmic aphakic or Pseudophakic eyes as well as in microphthalmic eyes without any history of eye surgery. Methods Thirty-two patients with a mean age of 6.41 ±5.24 years after congenital cataract surgery with absolute microcornea, i.e., horizontal corneal diameter (HCD) <10 mm, or relative microcornea, i.e., HCD 10–11 mm but in the affected eye at least 0.5 mm smaller compared to the fellow eye, formed group A. Thirteen patients of mean age 0.94±1.22 years with absolute or relative microcornea plus another developmental anomaly of an eye without any history of eye surgery formed group B. The patients with corneal edema or scars were excluded. The control group consisted of 124 healthy school-aged children. Horizontal corneal diameter was measured with caliper and CCT with an ultrasound pachymeter. In infants, these measurements were performed under general anesthesia. Results In 48 eyes in group A and in 16 eyes in group B, the mean CCT was 635.13±65.35 μm and 642.31±93.07 μm, respectively, which was significantly greater (p<0.0001 and p=0.0018) in comparison with the mean CCT (553.58±33.12 μm) in the control group. Regression curve demonstrated the significant increase of CCT values along with the decrease of HCD in microphthalmic eyes. Conclusions Small corneas in microphthalmic eyes either with or without congenital cataract surgery have significantly higher CCT. The results demonstrate significant negative correlation between horizontal corneal diameter and CCT.
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Park SH, Park YG, Lee MY, Kim MS. Clinical features of Korean patients with congenital aniridia. KOREAN JOURNAL OF OPHTHALMOLOGY 2010; 24:291-6. [PMID: 21052509 PMCID: PMC2955272 DOI: 10.3341/kjo.2010.24.5.291] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 05/11/2010] [Indexed: 12/03/2022] Open
Abstract
Purpose To investigate the clinical features of Korean patients with congenital aniridia. Methods This retrospective study focused on 60 eyes from 31 patients who were diagnosed with congenital aniridia at Kangnam St. Mary's Hospital from 1996 to 2007. Patient age, gender, visual acuity (VA), family history, and previous ocular history were recorded. The presence of keratopathy, glaucoma, cataract, foveal hypoplasia, and other ocular or systemic anomalies were evaluated for each patient. Results The proportion of sporadic cases was 29.0%. Cataract (82.5%), glaucoma (51.6%), keratopathy (71.6%), and foveal hypoplasia (81.8%) commonly accompanied aniridia. Thirty-four (60.7%) eyes had VAs less than 20/200 and 20 eyes (35.7%) had VAs between 20/200 and 20/60. In patients without a past history of ocular surgery, the mean central corneal thickness was 643.05 ± 37.67 µm and the mean endothelial cell count was 3,349.44 ± 408.17 cells/mm2. Ocular surface surgeries were performed in 6 eyes. The clarity of the transplanted corneal graft vanished in 5 eyes with the progression of peripheral neovascularization and subepithelial fibrosis. The mean age of cataract surgery in 8 eyes was 29.8 ± 5.9 years. Postoperative worsening of corneal clouding and glaucomatous damage were observed in 4 eyes. Two infants had bilateral congenital glaucoma. Two children with sporadic aniridia were identified to have Wilm's tumors. Conclusions Congenital aniridia is a progressive congenital disorder that is commonly accompanied by complications that can lead to impaired vision. Regular, careful examinations for these accompanying complications should be performed in all patients with congenital aniridia.
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Affiliation(s)
- Shin Hae Park
- Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Seoul, Korea
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Vasavada VA, Dixit NV, Ravat FA, Praveen MR, Shah SK, Vasavada V, Vasavada AR, Trivedi RH. Intraoperative performance and postoperative outcomes of cataract surgery in infant eyes with microphthalmos. J Cataract Refract Surg 2009; 35:519-28. [DOI: 10.1016/j.jcrs.2008.11.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2008] [Revised: 11/12/2008] [Accepted: 11/13/2008] [Indexed: 10/21/2022]
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Hikoya A, Sato M, Tsuzuki K, Koide YM, Asaoka R, Hotta Y. Central corneal thickness in Japanese children. Jpn J Ophthalmol 2009; 53:7-11. [DOI: 10.1007/s10384-008-0619-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Accepted: 09/26/2008] [Indexed: 12/17/2022]
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Chevallier B, Oberkampf B, Stheneur C. [Multidisciplinary management and paediatric Marfan syndrome]. Arch Pediatr 2008; 15:582-3. [PMID: 18582679 DOI: 10.1016/s0929-693x(08)71840-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- B Chevallier
- Service de Pédiatrie, Hôpital Ambroise Paré, APHP, Faculté Paris Ile de France Ouest, 9, avenue du général de Gaulle, Paris.
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Freedman SF. Central corneal thickness in children--does it help or hinder our evaluation of eyes at risk for glaucoma? J AAPOS 2008; 12:1-2. [PMID: 18314069 DOI: 10.1016/j.jaapos.2007.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Accepted: 12/14/2007] [Indexed: 10/22/2022]
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