Cataract formation after initial trabeculectomy in young patients.

Objective

To evaluate the risk of cataract formation in young patients after initial trabeculectomy.

Design

Retrospective, noncomparative case series.

Participants

Thirty-four eyes from 27 patients undergoing initial trabeculectomy at the Glaucoma Consultation Service, Massachusetts Eye and Ear Infirmary (mean age, 43.7 years; range, 12-54 years).

Intervention

Follow-up averaged 42.6 months (range, 11-90 months).

Methods

Lens status was observed before surgery and at 3 months; 6 months; and 1, 2, 3, 4, 5, and 6 years after initial trabeculectomy.

Main outcome measure: The main outcome measure was defined as cataract extraction for visually significant lenticular opacifications that developed after trabeculectomy.

Results

The rate of cataract extraction after initial trabeculectomy was 24% (n = 8). The average time from trabeculectomy to cataract extraction was 26 months (range, 5-58 months). Progression of lenticular opacities occurred throughout the follow-up period. There was no increased rate of cataract formation in subjects with uveitic and steroid-induced glaucoma when compared with all other types of glaucoma. In the patients with both eyes in the study, the first eye was a predictor of cataract progression in the fellow eye.

Conclusions

Cataract is a common complication after trabeculectomy in young patients. The 24% rate of cataract extraction after trabeculectomy reported in this study is a significant risk of which young patients contemplating surgery should be aware.