Nationwide incidence of and risk factors for undergoing incisional glaucoma surgery following infantile cataract surgery

Abstract

Nationwide incidence and risk factors for incisional glaucoma surgery post-infantile cataract (IC) surgery in children remain poorly understood. We conducted a population-based cohort study using the Korean national health claims database to identify IC patients diagnosed before age 1 who had IC surgery among all Korean born between 2008 and 2018 (n = 9,593,003). We estimated the annual occurrence of undergoing incisional glaucoma surgery following IC surgery in the general population aged 0-10. The risk factors for incisional surgery including systemic comorbidities and ophthalmic anomalies were analyzed by multivariable logistic regression. Of 650 patients who had undergone IC surgery with a mean (standard deviation [SD]) follow-up period of 6.2 (3.2) years, 92 (14.2%) were diagnosed with glaucoma following infantile cataract surgery (GFICS). Among them, 21 patients (22.8%) underwent incisional glaucoma surgery after a mean (SD) follow-up duration of 5.4 (2.8) years from the diagnosis of GFICS. Median (InterQuartile Range) age at incisional surgery was 4 (2,6) years old. Twenty of 21 patients (95.2%) underwent incisional glaucoma surgery within 3 years of diagnosis of GFICS. No factors, except younger age at glaucoma diagnosis (P = 0.03), were associated with undergoing incisional surgery. These findings can better understand the epidemiologic features and clinical courses of GFICS.

Keywords: Congenital; Glaucoma; Incidence; Infantile cataract; Risk; Surgery.

Figure 1

Flowchart of study subjects.

Figure 2

Cumulative incidence graph of GFICS cases with incisional glaucoma surgery. (A) Cumulative incidence graph of total population. The incidence of incisional glaucoma surgery gradually increased until 3 years after diagnosis of GFICS. (B) Cumulative incidence graph by sex. There was no significant difference between males and females (P = 0.279).