Secondary Glaucoma after Congenital Cataract Surgery: A Serious Complication not to be Missed

Abstract

Secondary glaucoma is a serious complication in patients who have already undergone surgery for congenital cataract. We report the case of a 27 year old female patient, operated on at the age of 3 weeks for bilateral congenital cataract, subsequently complicated by secondary glaucoma, followed since paediatric age; admitted to our department on dual hypotonic therapy. Glaucoma and suspected glaucoma develop in 50% or more of children who have undergone congenital cataract surgery. The risk of developing glaucoma is the same whether patients remain aphakic or receive an implant at the time of cataract extraction. Most often, these glaucomas develop within 3 years of the surgical procedure. Pediatric patients with surgically controlled intraocular pressure (IOP) may still have morbidities related to previous IOP elevation, including amblyopia, corneal scarring, strabismus, anisometropia, trauma susceptibility due to scleral fragility, and recurrent IOP elevation. These morbidities can lead to severe long-term visual impairment and should be treated promptly.