Incidence of Glaucoma-Related Adverse Events in the First 5 Years After Pediatric Lensectomy
Importance: Glaucoma can develop following cataract removal in children.
Objective: To assess the cumulative incidence of glaucoma-related adverse events (defined as glaucoma or glaucoma suspect) and factors associated with risk of these adverse events in the first 5 years after lensectomy prior to 13 years of age.
Design, Setting, and Participants: This cohort study used longitudinal registry data collected at enrollment and annually for 5 years from 45 institutional and 16 community sites. Participants were children aged 12 years or younger with at least 1 office visit after lensectomy from June 2012 to July 2015. Data were analyzed from February through December 2022.
Exposures: Usual clinical care after lensectomy.
Main Outcomes and Measures: The main outcomes were cumulative incidence of glaucoma-related adverse events and baseline factors associated with risk of these adverse events.
Results: The study included 810 children (1049 eyes); 443 eyes of 321 children (55% female; mean [SD] age, 0.89 [1.97] years) were aphakic after lensectomy, and 606 eyes of 489 children (53% male; mean [SD] age, 5.65 [3.32] years) were pseudophakic. The 5-year cumulative incidence of glaucoma-related adverse events was 29% (95% CI, 25%-34%) in 443 eyes with aphakia and 7% (95% CI, 5%-9%) in 606 eyes with pseudophakia; 7% (95% CI, 5%-10%) of aphakic eyes and 3% (95% CI, 2%-5%) of pseudophakic eyes were diagnosed as glaucoma suspect. Among aphakic eyes, a higher risk for glaucoma-related adverse events was associated with 4 of 8 factors, including age less than 3 months (vs ≥3 months: adjusted hazard ratio [aHR], 2.88; 99% CI, 1.57-5.23), abnormal anterior segment (vs normal: aHR, 2.88; 99% CI, 1.56-5.30), intraoperative complications at time of lensectomy (vs none; aHR, 2.25; 99% CI, 1.04-4.87), and bilaterality (vs unilaterality: aHR, 1.88; 99% CI, 1.02-3.48). Neither of the 2 factors evaluated for pseudophakic eyes, laterality and anterior vitrectomy, were associated with risk of glaucoma-related adverse events.
Conclusions and Relevance: In this cohort study, glaucoma-related adverse events were common after cataract surgery in children; age less than 3 months at surgery was associated with elevated risk of the adverse events in aphakic eyes. Children with pseudophakia, who were older at surgery, less frequently developed a glaucoma-related adverse event within 5 years of lensectomy. The findings suggest that ongoing monitoring for the development of glaucoma is needed after lensectomy at any age.
| Errataetall: |
CommentIn: JAMA Ophthalmol. 2023 Apr 1;141(4):331-332. - PMID 36795407 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:141 |
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| Enthalten in: |
JAMA ophthalmology - 141(2023), 4 vom: 01. Apr., Seite 324-331 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bothun, Erick D [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 24.04.2023 Date Revised 17.02.2024 published: Print CommentIn: JAMA Ophthalmol. 2023 Apr 1;141(4):331-332. - PMID 36795407 Citation Status MEDLINE |
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| doi: |
10.1001/jamaophthalmol.2022.6413 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Bothun, Erick D |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Incidence of Glaucoma-Related Adverse Events in the First 5 Years After Pediatric Lensectomy |
| 264 | 1 | |c 2023 | |
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| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 24.04.2023 | ||
| 500 | |a Date Revised 17.02.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: JAMA Ophthalmol. 2023 Apr 1;141(4):331-332. - PMID 36795407 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Importance: Glaucoma can develop following cataract removal in children | ||
| 520 | |a Objective: To assess the cumulative incidence of glaucoma-related adverse events (defined as glaucoma or glaucoma suspect) and factors associated with risk of these adverse events in the first 5 years after lensectomy prior to 13 years of age | ||
| 520 | |a Design, Setting, and Participants: This cohort study used longitudinal registry data collected at enrollment and annually for 5 years from 45 institutional and 16 community sites. Participants were children aged 12 years or younger with at least 1 office visit after lensectomy from June 2012 to July 2015. Data were analyzed from February through December 2022 | ||
| 520 | |a Exposures: Usual clinical care after lensectomy | ||
| 520 | |a Main Outcomes and Measures: The main outcomes were cumulative incidence of glaucoma-related adverse events and baseline factors associated with risk of these adverse events | ||
| 520 | |a Results: The study included 810 children (1049 eyes); 443 eyes of 321 children (55% female; mean [SD] age, 0.89 [1.97] years) were aphakic after lensectomy, and 606 eyes of 489 children (53% male; mean [SD] age, 5.65 [3.32] years) were pseudophakic. The 5-year cumulative incidence of glaucoma-related adverse events was 29% (95% CI, 25%-34%) in 443 eyes with aphakia and 7% (95% CI, 5%-9%) in 606 eyes with pseudophakia; 7% (95% CI, 5%-10%) of aphakic eyes and 3% (95% CI, 2%-5%) of pseudophakic eyes were diagnosed as glaucoma suspect. Among aphakic eyes, a higher risk for glaucoma-related adverse events was associated with 4 of 8 factors, including age less than 3 months (vs ≥3 months: adjusted hazard ratio [aHR], 2.88; 99% CI, 1.57-5.23), abnormal anterior segment (vs normal: aHR, 2.88; 99% CI, 1.56-5.30), intraoperative complications at time of lensectomy (vs none; aHR, 2.25; 99% CI, 1.04-4.87), and bilaterality (vs unilaterality: aHR, 1.88; 99% CI, 1.02-3.48). Neither of the 2 factors evaluated for pseudophakic eyes, laterality and anterior vitrectomy, were associated with risk of glaucoma-related adverse events | ||
| 520 | |a Conclusions and Relevance: In this cohort study, glaucoma-related adverse events were common after cataract surgery in children; age less than 3 months at surgery was associated with elevated risk of the adverse events in aphakic eyes. Children with pseudophakia, who were older at surgery, less frequently developed a glaucoma-related adverse event within 5 years of lensectomy. The findings suggest that ongoing monitoring for the development of glaucoma is needed after lensectomy at any age | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 700 | 1 | |a Repka, Michael X |e verfasserin |4 aut | |
| 700 | 1 | |a Kraker, Raymond T |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Rui |e verfasserin |4 aut | |
| 700 | 1 | |a Leske, David A |e verfasserin |4 aut | |
| 700 | 1 | |a Hatt, Sarah R |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Zhuokai |e verfasserin |4 aut | |
| 700 | 1 | |a Freedman, Sharon F |e verfasserin |4 aut | |
| 700 | 1 | |a Astle, William F |e verfasserin |4 aut | |
| 700 | 1 | |a Cotter, Susan A |e verfasserin |4 aut | |
| 700 | 1 | |a Holmes, Jonathan M |e verfasserin |4 aut | |
| 700 | 0 | |a Pediatric Eye Disease Investigator Group |e verfasserin |4 aut | |
| 700 | 1 | |a Wallace, David K |e investigator |4 oth | |
| 700 | 1 | |a Enyedi, Laura B |e investigator |4 oth | |
| 700 | 1 | |a Prakalapakorn, Sasapin |e investigator |4 oth | |
| 700 | 1 | |a Jones, Sarah K |e investigator |4 oth | |
| 700 | 1 | |a Hug, Denise |e investigator |4 oth | |
| 700 | 1 | |a Stahl, Erin D |e investigator |4 oth | |
| 700 | 1 | |a Dent, Rebecca J |e investigator |4 oth | |
| 700 | 1 | |a Kong, Lingkun |e investigator |4 oth | |
| 700 | 1 | |a Wang, Serena |e investigator |4 oth | |
| 700 | 1 | |a Gallerson, Bryan K |e investigator |4 oth | |
| 700 | 1 | |a Hutchinson, Amy K |e investigator |4 oth | |
| 700 | 1 | |a Lenhart, Phoebe |e investigator |4 oth | |
| 700 | 1 | |a Brower, Judy |e investigator |4 oth | |
| 700 | 1 | |a Morrison, David G |e investigator |4 oth | |
| 700 | 1 | |a Ruark, Scott T |e investigator |4 oth | |
| 700 | 1 | |a Mets-Halgrimson, Rebecca |e investigator |4 oth | |
| 700 | 1 | |a Yoon, Hawke |e investigator |4 oth | |
| 700 | 1 | |a Ralay-Ranaivo, Hantamalala |e investigator |4 oth | |
| 700 | 1 | |a Hamidullah, Aaliyah |e investigator |4 oth | |
| 700 | 1 | |a Areaux, Raymond |e investigator |4 oth | |
| 700 | 1 | |a Anderson, Jill S |e investigator |4 oth | |
| 700 | 1 | |a Holleschau, Ann M |e investigator |4 oth | |
| 700 | 1 | |a Superstein, Rosanne |e investigator |4 oth | |
| 700 | 1 | |a Belanger, Caroline |e investigator |4 oth | |
| 700 | 1 | |a Fallaha, Nicole |e investigator |4 oth | |
| 700 | 1 | |a Hamel, Patrick |e investigator |4 oth | |
| 700 | 1 | |a Thibeault, Maryse |e investigator |4 oth | |
| 700 | 1 | |a Tamkins, Susanna M |e investigator |4 oth | |
| 700 | 1 | |a Chang, Ta |e investigator |4 oth | |
| 700 | 1 | |a Park, Hee-Jung S |e investigator |4 oth | |
| 700 | 1 | |a Trumler, Anya A |e investigator |4 oth | |
| 700 | 1 | |a Liu, Xiaonong |e investigator |4 oth | |
| 700 | 1 | |a Sanders, Emi N |e investigator |4 oth | |
| 700 | 1 | |a Traboulsi, Elias |e investigator |4 oth | |
| 700 | 1 | |a Ghasia, Fatema |e investigator |4 oth | |
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| 700 | 1 | |a Bowman, Corey S |e investigator |4 oth | |
| 700 | 1 | |a Galvin, Jennifer |e investigator |4 oth | |
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| 700 | 1 | |a Grigorian, Adriana P |e investigator |4 oth | |
| 700 | 1 | |a Baird, Alicia M |e investigator |4 oth | |
| 700 | 1 | |a Strominger, Mitchell B |e investigator |4 oth | |
| 700 | 1 | |a Chen, Vicki |e investigator |4 oth | |
| 700 | 1 | |a Klein, Shelley |e investigator |4 oth | |
| 700 | 1 | |a Kemmer, Jacquelyn D |e investigator |4 oth | |
| 700 | 1 | |a Neiman, Alexandra E |e investigator |4 oth | |
| 700 | 1 | |a Mendoza, Myra N |e investigator |4 oth | |
| 700 | 1 | |a Frohwein, Jill J |e investigator |4 oth | |
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| 700 | 1 | |a Clarke, Michael P |e investigator |4 oth | |
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| 700 | 1 | |a Powell, Christine |e investigator |4 oth | |
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| 700 | 1 | |a Gearinger, Matthew D |e investigator |4 oth | |
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