Incidence Rate of Secondary Glaucoma Following Congenital Cataract Surgery: An In-Depth Systematic Review and Meta-Analysis

Abstract

Purpose

To assess the incidence of secondary glaucoma in children following congenital cataract surgery.

Design

Systematic review and meta-analysis.

Methods

The PubMed, Embase, Cochrane Library, and Web of Science databases were searched from inception through March 16, 2023. Studies reporting congenital cataract surgery and glaucoma were enrolled. The quality of the selected studies was assessed using the Newcastle Ottawa Scale, and data analysis was executed utilizing R software.

Results

A total of 36 published studies with 3,151 patients (4,717 eyes) were included in the analysis. The incidence rate of glaucoma following congenital cataract surgery was 6.6% (95% CI: 3.9%, 9.9%). The incidence of secondary glaucoma in the primary intraocular lens (IOL) implantation group [3.3% (95% CI: 1.5%, 5.8%)] and the secondary IOL implantation group [3.5% (95% CI: 0%, 11.4%)] were lower compared to the aphakia group [13.5% (95% CI: 7.7%, 20.6%)]. The incidence rate among children with congenital cataracts from Asia [6.9% (95% CI: 4.1%, 10.4%)] was higher than that in European children [0.9% (95% CI: 0%, 3.0%)] (p < 0.01). A correlation was identified between the age at cataract surgery and the incidence of secondary glaucoma (p = 0.0215).

Conclusions

This meta-analysis found that the incidence of secondary glaucoma following congenital cataract surgery is approximately 6.6%. Children with IOL implantation exhibit a lower incidence of secondary glaucoma, with a lower incidence noted in European children compared to their Asian counterparts. The age at cataract surgery is an important risk factor to consider.