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TOPLINE:

Use of low-dose glucocorticoids after cataract surgery reduces the risk for secondary glaucoma in children with longer axial lengths over 5 years compared with high-dose glucocorticoids.

METHODOLOGY:

• To examine the relationship between the postoperative dose of glucocorticoids and the development of secondary glaucoma following pediatric cataract surgery, researchers retrospectively reviewed the records of children who underwent cataract surgery until 2016 and prospectively followed those treated from 2017 to 2021.
• The study included 267 consecutive children (388 eyes; 120 girls) before the age of 10 years from two specialized centers in Denmark.
• Participants received treatment with either low-dose (n = 173) or high-dose (n = 95) glucocorticoids after surgery, with a median follow-up period of 40.5 months for the low-dose group and 89 months for the high-dose group.
• The primary outcome was the incidence of glaucoma or ocular hypertension lasting over 3 months after surgery; the secondary outcome was the incidence of opacification of the visual axis.

TAKEAWAY:

• Overall, 21 children (34 eyes) were diagnosed with glaucoma or ocular hypertension, with both eyes affected in 13 children.
• Use of low-dose glucocorticoids after surgery significantly reduced the risk for secondary glaucoma or ocular hypertension in children with axial lengths of ≥ 18 mm vs high-dose treatment (P = .0008). This effect was not found in those with axial lengths < 18 mm.
• The risk for glaucoma or ocular hypertension was estimated to be 10% in the high-dose group and 1% in the low-dose group in the first 2 years after surgery.
• Opacity of the visual axis was reported in 57 children (69 eyes). The incidences were similar with high and low doses of corticosteroids.

IN PRACTICE:

"We report a lower risk of glaucoma 5 years after cataract surgery in children with axial lengths ≥ 18 mm receiving low-dose versus high-dose postoperative local and topical glucocorticoid treatment. This effect was not present in children with shorter axial lengths," the authors wrote.

SOURCE:

The study was led by Diana Chabané Schmidt from the Copenhagen University Hospital, Rigshospitalet in Copenhagen, Denmark. It was published online on August 12, 2024, in Acta Ophthalmologica.

LIMITATIONS:

The findings were limited by noninterventional design, selection bias, and the presence of unknown confounders. The wide age range could have affected the risk for secondary glaucoma.

DISCLOSURES:

The Danish Eye Research Foundation, Helsefonden, Fight for Sight, Synoptik Foundation, Fabrikant Einar Willumsens Mindelegat, Beckett-Fonden, Th. Maigaards efterfølger fru Lily Benthine Lunds fond af 1.6.1978, Kong Christian den Tiendes Fond, and Helene and Viggo Bruuns Foundation supported the study. The authors did not declare any conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.