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Presentation typeOral presentation
TitleManagement of childhood glaucoma following cataract surgery: a systematic review
PurposeThe optimal management approach for 'glaucoma following cataract surgery' (GFCS), one of the paediatric glaucoma subtypes, is an ongoing debate. This review assesses the success rates and risk factors associated with the various management options available and aims to propose a clinical management strategy for GFCS cases, based on current literature.
MethodsA literature search was conducted, following the PRISMA Statement 2009 criteria, in three large bibliographic databases (Cochrane, PubMed, Embase, and Web of Science), from 1995 up to April 2021.
ResultsThirty-nine studies – presenting (1) eyes with GFCS; a disease entity as defined by the Glaucoma Research Network Classification, (2) data on treatment outcomes, and (3) follow-up data of at least 6 months – were included. Multiple surgical procedures are often required to adequately control GFCS. Included papers report on GFCS treated with angle surgery, trabeculectomy, glaucoma drainage device implantation and cyclodestructive procedures. Several factors are associated with reduced outcomes of particular surgical procedures.
ConclusionMedical therapy should be considered the initial strategy of choice in GFCS, possibly to bridge time to surgery. Current literature suggests that GDD implantation is the preferred initial surgical approach in young children, especially if aphakic and contact lens dependent. Trabeculectomy may be suitable for older and more co-operative children who are pseudophakic. For the management of individual GFCS cases, a flowchart is suggested which takes into account patient-related risk factors for failure, and which may assist in clinical decision-making.
Conflict of interestNo
Authors 1
Last nameSIMONS
InitialsA
DepartmentUZ Leuven
CityLeuven
Authors 2
Last nameLemmens
InitialsS
DepartmentUZ Leuven
CityLeuven
Authors 3
Last nameGrigg
InitialsJ
DepartmentUniversity of Sydney
CitySydney
Authors 4
Last nameCasteels
InitialsI
DepartmentUZ Leuven
CityLeuven
Authors 5
Last nameStalmans
InitialsI
DepartmentUZ Leuven
CityLeuven
Authors 6
Last nameVandewalle
InitialsE
DepartmentUZ Leuven
CityLeuven
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