For children two and under who have undergone cataract surgery, a younger age at the time of the procedure and a smaller ocular size may put them at greater risk of developing glaucoma, a research team from the UK reports.

The investigation found other glaucoma risk factors for children with bilateral cataract included the presence of significant ocular comorbidity and shorter axial length. For children with unilateral cataracts, the study reported shorter axial length was the only glaucoma risk factor.

The investigation included 254 children aged two or younger who had cataract surgery, 235 of whom, or 93%, had complete follow-up data.

Five years after surgery, the study found 20% of children with bilateral cataract and 12% with unilateral cataract developed secondary glaucoma. The researchers also noted glaucoma-related complications, which the study defined as any that involved elevated intraocular pressure, were diagnosed in 24% of children with bilateral cataracts and 36% of children who had unilateral cataracts.

Both younger age at surgery (the strongest marker of ocular “immaturity”) and smaller ocular size (a marker of both immaturity and developmental vulnerability) can be used to identify those at greatest risk of glaucoma due to early life cataract surgery, the researchers said in their paper.

Solebo AL, Rahi. Glaucoma following cataract surgery in the first 2 years of life: frequency, risk factors and outcomes from IoLunder2. Br J Ophthalmol. October 5, 2019. [Epub ahead or print].