{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T11:44:00Z","timestamp":1783338240621,"version":"3.54.6"},"reference-count":46,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970778"],"award-info":[{"award-number":["81970778"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Program of China","award":["2020YFC2008200"],"award-info":[{"award-number":["2020YFC2008200"]}]},{"DOI":"10.13039\/501100021171","name":"Guangdong Basic and Applied Basic Research Foundation","doi-asserted-by":"crossref","award":["2020A1515010987"],"award-info":[{"award-number":["2020A1515010987"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2023,2,8]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To report the incidence and associated risk factors for developing suspected and definitive glaucoma after bilateral congenital cataract (CC) removal with a 5-year follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Secondary analysis of a prospective longitudinal cohort study. Bilateral CC patients who had undergone cataract surgery between January 2011 and December 2014 at Zhongshan Ophthalmic Centre were recruited. Suspected glaucoma was defined as persistent ocular hypertension requiring medical treatment. Definitive glaucoma was defined as accompanied by the progression of glaucomatous clinical features. According to postoperative lens status in 5 years follow-up: 130 eyes in the aphakia group; 219 in the primary intraocular lens (IOL) implantation group and 337 in the secondary IOL implantation group. The Kaplan-Meier survival and Cox regression analyses were used to explore the cumulative incidence and risk factors for suspected and definitive glaucoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three hundred fifty-one children (686 eyes) with bilateral CCs were enrolled in the study. The mean age at surgery was 1.82\u00b12.08 years, and the mean follow-up duration was 6.26\u00b10.97 years. Suspected and definitive glaucoma developed at a mean time of 2.84\u00b11.75 years (range 0.02\u20137.33 years) postoperatively. The cumulative incidence of suspected and definitive glaucoma was 9.97% (35 of 351 patients), including 6.12% (42 eyes) for definitive glaucoma and 2.48% (17 eyes) for suspected glaucoma. Microcornea (HR 4.103, p&lt;0.0001), CC family history (HR 3.285, p=0.001) and initial anterior vitrectomy (HR 2.365 p=0.036) were risk factors for suspected and definitive glaucoma. Gender, age at surgery, intraocular surgery frequency, length of follow-up and frequency of neodymium-doped yttrium aluminumaluminium garnet laser were non-statistically significant. Primary IOL implantation was a protective factor (HR 0.378, p=0.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Identifying suspected and definitive glaucoma after bilateral CC surgery can lower the risk of secondary blindness in children. Patients with related risk factors need to pay more attention and thus reach early intervention and treatment during clinical practice. Primary IOL implantation may be a potential protective factor, need more clinical trials to be verified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04342052\">NCT04342052<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjo-2022-322589","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T18:20:21Z","timestamp":1677262821000},"page":"476-483","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Incidence of and risk factors for suspected and definitive glaucoma after bilateral congenital cataract surgery: a 5-year follow-up"],"prefix":"10.1136","volume":"108","clinical-trial-number":[{"clinical-trial-number":"nct04342052","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Jinghui","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianghua","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiwei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengqi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duoru","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiayin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruixin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenzhen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuoling","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizhi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4672-9721","authenticated-orcid":false,"given":"Haotian","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3023-4057","authenticated-orcid":false,"given":"Weirong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,2,24]]},"reference":[{"key":"2024022109050592000_108.3.476.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2007.09.002"},{"key":"2024022109050592000_108.3.476.2","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/S0002-9394(14)72563-2","article-title":"Lens-induced glaucoma 65 years after congenital cataract surgery","volume":"118","author":"Barnhorst","year":"1994","journal-title":"Am J Ophthalmol"},{"key":"2024022109050592000_108.3.476.3","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1111\/j.1755-3768.2009.01633.x","article-title":"Glaucoma in aphakic and pseudophakic eyes following surgery for congenital cataract in the first year of life","volume":"88","author":"Kirwan","year":"2010","journal-title":"Acta Ophthalmol"},{"key":"2024022109050592000_108.3.476.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2013.03.013"},{"key":"2024022109050592000_108.3.476.5","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2008.155200"},{"key":"2024022109050592000_108.3.476.6","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0000000000000516"},{"key":"2024022109050592000_108.3.476.7","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1111\/ceo.12067","article-title":"Incidence and predictors of glaucoma following surgery for congenital cataract in the first year of life in Victoria, Australia","volume":"41","author":"Ruddle","year":"2013","journal-title":"Clin Exp Ophthalmol"},{"key":"2024022109050592000_108.3.476.8","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jaapos.2012.11.009","article-title":"Glaucoma after pediatric cataract surgery in a population with limited access to care","volume":"17","author":"Baden","year":"2013","journal-title":"J AAPOS"},{"key":"2024022109050592000_108.3.476.9","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2014-306394"},{"key":"2024022109050592000_108.3.476.10","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.ajo.2016.08.012","article-title":"Primary congenital glaucoma versus glaucoma following congenital cataract surgery: comparative clinical features and long-term outcomes","volume":"170","author":"Neustein","year":"2016","journal-title":"Am J Ophthalmol"},{"key":"2024022109050592000_108.3.476.11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0069867","article-title":"Ocular hypertension after pediatric cataract surgery: baseline characteristics and first-year report","volume":"8","author":"Lin","year":"2013","journal-title":"PLoS One"},{"key":"2024022109050592000_108.3.476.12","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/IJG.0000000000001398","article-title":"Incidence of and risk factors for suspected glaucoma and glaucoma after congenital and infantile cataract surgery: a longitudinal study in China","volume":"29","author":"Wang","year":"2020","journal-title":"J Glaucoma"},{"key":"2024022109050592000_108.3.476.13","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1001\/jamaophthalmol.2019.4571","article-title":"Incidence and management of glaucoma or glaucoma suspect in the first year after pediatric lensectomy","volume":"138","author":"Freedman","year":"2020","journal-title":"JAMA Ophthalmol"},{"key":"2024022109050592000_108.3.476.14","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1001\/jamaophthalmol.2015.1329","article-title":"Glaucoma-related adverse events in the first 5 years after unilateral cataract removal in the infant aphakia treatment study","volume":"133","author":"Freedman","year":"2015","journal-title":"JAMA Ophthalmol"},{"key":"2024022109050592000_108.3.476.15","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0420.2000.078001065.x"},{"key":"2024022109050592000_108.3.476.16","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1001\/jamaophthalmol.2020.5664","article-title":"Glaucoma-related adverse events at 10 years in the infant aphakia treatment study: a secondary analysis of a randomized clinical trial","volume":"139","author":"Freedman","year":"2021","journal-title":"JAMA Ophthalmol"},{"key":"2024022109050592000_108.3.476.17","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.ajo.2019.08.005","article-title":"Incidence and risk factors for glaucoma development after bilateral congenital cataract surgery in microphthalmic eyes","volume":"208","author":"Kim","year":"2019","journal-title":"Am J Ophthalmol"},{"key":"2024022109050592000_108.3.476.18","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1007\/s00417-014-2908-8","article-title":"Cataract surgery in infants with microphthalmos","volume":"253","author":"Prasad","year":"2015","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"2024022109050592000_108.3.476.19","unstructured":"World Glaucoma Association WRN . Childhood glaucoma: the 9th consensus report of the world glaucoma association; 2013."},{"key":"2024022109050592000_108.3.476.20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0214684","article-title":"The role of primary intraocular lens implantation in the risk of secondary glaucoma following congenital cataract surgery: a systematic review and meta-analysis","volume":"14","author":"Zhang","year":"2019","journal-title":"PLoS ONE"},{"key":"2024022109050592000_108.3.476.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.06.046"},{"key":"2024022109050592000_108.3.476.22","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2009.160069"},{"key":"2024022109050592000_108.3.476.23","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1016\/j.ophtha.2019.03.011","article-title":"Outcomes of unilateral cataracts in infants and toddlers 7 to 24 months of age: toddler aphakia and pseudophakia study (TAPS)","volume":"126","author":"Bothun","year":"2019","journal-title":"Ophthalmology"},{"key":"2024022109050592000_108.3.476.24","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/S2352-4642(18)30317-1","article-title":"5-year outcomes after primary intraocular lens implantation in children aged 2 years or younger with congenital or infantile cataract: findings from the iolunder2 prospective inception cohort study","volume":"2","author":"Solebo","year":"2018","journal-title":"Lancet Child Adolesc Health"},{"key":"2024022109050592000_108.3.476.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.06.017"},{"key":"2024022109050592000_108.3.476.26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/sj.eye.6700288","article-title":"Meeting the challenge of glaucoma after paediatric cataract surgery","volume":"17","author":"Papadopoulos","year":"2003","journal-title":"Eye (Lond)"},{"key":"2024022109050592000_108.3.476.27","doi-asserted-by":"crossref","first-page":"923","DOI":"10.18240\/ijo.2021.06.19","article-title":"Commentary review: challenges of intraocular lens implantation for congenital cataract infants","volume":"14","author":"Zhao","year":"2021","journal-title":"Int J Ophthalmol"},{"key":"2024022109050592000_108.3.476.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2007.06.047"},{"key":"2024022109050592000_108.3.476.29","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.jcjo.2019.01.003","article-title":"Intraocular lens implantation as an isolated risk factor for secondary glaucoma in pediatric patients","volume":"54","author":"Yagev","year":"2019","journal-title":"Can J Ophthalmol"},{"key":"2024022109050592000_108.3.476.30","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-8531(00)90009-0"},{"key":"2024022109050592000_108.3.476.31","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1038\/s41433-018-0316-8","article-title":"Prospective analysis of the predictors of glaucoma following surgery for congenital and infantile cataract","volume":"33","author":"Balekudaru","year":"2019","journal-title":"Eye (Lond)"},{"key":"2024022109050592000_108.3.476.32","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.ophtha.2018.08.031","article-title":"Childhood lensectomy is associated with static and dynamic reduction in schlemm canal size: a biomechanical hypothesis of glaucoma after lensectomy","volume":"126","author":"Daniel","year":"2019","journal-title":"Ophthalmology"},{"key":"2024022109050592000_108.3.476.33","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/j.1755-3768.2010.01872.x","article-title":"Long-term results of bilateral congenital cataract treated with early cataract surgery, aphakic glasses and secondary IOL implantation","volume":"90","author":"Kim","year":"2012","journal-title":"Acta Ophthalmol"},{"key":"2024022109050592000_108.3.476.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2005.10.002"},{"key":"2024022109050592000_108.3.476.35","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2003.040378"},{"key":"2024022109050592000_108.3.476.36","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2011.347"},{"key":"2024022109050592000_108.3.476.37","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(03)00871-7"},{"key":"2024022109050592000_108.3.476.38","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S1091-8531(02)42009-5","article-title":"Complications in infants undergoing surgery for congenital cataract in the first 12 weeks of life: is early surgery better?","volume":"7","author":"Watts","year":"2003","journal-title":"J AAPOS"},{"key":"2024022109050592000_108.3.476.39","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.21037\/atm-20-3033","article-title":"Recent developments in the management of congenital cataract","volume":"8","author":"Bremond-Gignac","year":"2020","journal-title":"Ann Transl Med"},{"key":"2024022109050592000_108.3.476.40","first-page":"1","article-title":"Current status of IOL implantation in pediatric eyes: an update","volume":"2017","author":"Vasavada","year":"2017","journal-title":"Expert Rev Med Devices"},{"key":"2024022109050592000_108.3.476.41","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1001\/jamaophthalmol.2014.531","article-title":"Comparison of contact lens and intraocular lens correction of monocular aphakia during infancy: a randomized clinical trial of HOTV optotype acuity at age 4.5 years and clinical findings at age 5 years","volume":"132","author":"Lambert","year":"2014","journal-title":"JAMA Ophthalmol"},{"key":"2024022109050592000_108.3.476.42","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.4103\/0301-4738.149131","article-title":"Long-term results after primary intraocular lens implantation in children operated less than 2 years of age for congenital cataract","volume":"62","author":"Sukhija","year":"2014","journal-title":"Indian J Ophthalmol"},{"key":"2024022109050592000_108.3.476.43","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/j.jcrs.0000000000000015","article-title":"Comparison of visual acuity and complications between primary IOL implantation and aphakia in patients with congenital cataract younger than 2 years: a meta-analysis","volume":"46","author":"Chen","year":"2020","journal-title":"J Cataract Refract Surg"},{"key":"2024022109050592000_108.3.476.44","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1016\/j.jcrs.2015.10.005","article-title":"Long-term postoperative outcomes after bilateral congenital cataract surgery in eyes with microphthalmos","volume":"41","author":"Praveen","year":"2015","journal-title":"J Cataract Refract Surg"},{"key":"2024022109050592000_108.3.476.45","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/aos.13974","article-title":"Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta-analysis based on randomized and controlled trials","volume":"97","author":"Cao","year":"2019","journal-title":"Acta Ophthalmol"},{"key":"2024022109050592000_108.3.476.46","unstructured":"World Glaucoma Association . Consensus (conference) (9th: 2013: vancouver BC. childhood glaucoma [electronic resource]: the 9th consensus report of the world glaucoma association. Amsterdam, The Netherlands Kugler Publications; 2013."}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2022-322589","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T17:09:25Z","timestamp":1708535365000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2022-322589"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,24]]},"references-count":46,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,2,21]]},"published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1136\/bjo-2022-322589"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2022-322589","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,24]]}}}