Cataract formation after initial trabeculectomy in young patients.

Abstract

To evaluate the risk of cataract formation in young patients after initial trabeculectomy. Retrospective, noncomparative case series. 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). Follow-up averaged 42.6 months (range, 11-90 months). Lens status was observed before surgery and at 3 months; 6 months; and 1, 2, 3, 4, 5, and 6 years after initial trabeculectomy. The main outcome measure was defined as cataract extraction for visually significant lenticular opacifications that developed after trabeculectomy. 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. 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.