A European study investigating cataract surgery (GFCS) in children found an age of less than 16 weeks and presence of microcornea and other anterior segment abnormalities at the time of surgery were associated with increased risk of glaucoma. 

The Portuguese and Belgian research team studied a total of 110 eyes from 74 patients under the age of 18 years – 38 with unilateral and 36 with bilateral paediatric cataract surgery – with a follow-up of around 10 years. Of these patients, 25.45% developed GFCS after an average follow-up of 9.96 (± 3.64) years after cataract surgery, with 20% becoming glaucoma suspects.  

Cataract surgery before 12 weeks of age is generally considered the critical factor for increasing GFCS risk, said researchers. “Nonetheless, in our study, performing surgery before 16 weeks of age was also significantly associated with an increased risk of developing GFCS, in both univariable and multivariable analyses, while performing surgery before 28 weeks of age was not associated with the development of GFCS in multivariable analysis.”  

It has been postulated that the higher intraoperative tissue manipulation in younger, smaller eyes, combined with an increased uveal reactivity and a less developed trabecular meshwork, with smaller intertrabecular spaces, could explain the importance of age at surgery for the risk of development of GFCS, they said. 

The study was published in Journal of Glaucoma.