Association of Age With Glaucoma and Visual Acuity Outcomes 10.5 Years After Unilateral Congenital Cataract Surgery

Abstract

Objective: To determine the association among age, gestational age, glaucoma-related adverse events, and visual acuity following unilateral cataract surgery.

Design: Post hoc follow-up of a multicenter randomized clinical trial.

Methods: An analysis of 112 infants who had unilateral congenital cataract surgery between 1-6 months of chronological age. Data on long-term glaucoma-related status and visual acuity were collected when children were 10.5 years old. Intergroup comparison and correlation tests were performed, and associations of adjusted and chronological age with glaucoma and visual acuity at 10.5 years of age were assessed by logistic regression.

Results: Chronological and adjusted age were highly correlated (Pearson correlation, r = 0.98, P < .001). Gestational age was not significantly associated with glaucoma (P = .08) nor visual acuity (P = .6). Younger adjusted age had a significant association with glaucoma (P = .04) and with better visual acuity (P = .03). Younger chronological age was not significantly associated with glaucoma (P = .06) but had a significant association with better visual acuity (P = .02).

Conclusions: Age adjusted for gestation and chronological age are important risk factors for glaucoma and visual acuity in patients who have undergone cataract removal in infancy. Among the IATS participants, age adjusted for gestation significantly predicted glaucoma-related adverse events at 10.5 years. Conversely, chronological age was significantly associated with visual acuity at 10.5 years. Adjusted age should be considered in addition to chronological age when determining age of cataract surgery to minimize the risk of glaucoma and maximize visual acuity.