Característica clínicas de pacientes com glaucoma pós-cirurgia de catarata congênita em hospital universitário de referência

Abstract

Congenital cataract is a major cause of reversible childhood blindness, and although surgical treatment is essential, it may lead to significant complications, including glaucoma. This cross-sectional, retrospective, observational study evaluated the clinical characteristics of patients who developed glaucoma after congenital cataract surgery at the Pediatric Ophthalmology Service of HUPES-UFBA between July 2017 and June 2023. Among 145 operated patients (225 eyes), 4.8% developed postoperative glaucoma (10 eyes). Most affected patients underwent surgery between 4 and 6 months of age, a period associated with increased glaucoma risk. Systemic comorbidities—especially Down syndrome—were present in 57% of glaucoma cases. All patients underwent lensectomy with posterior capsulotomy and anterior vitrectomy, without intraocular lens implantation. Glaucoma was diagnosed on average 37 months after surgery, with a mean intraocular pressure of 26.4 mmHg and a mean optic disc cupping of 0.65. Multiple interventions were often required for pressure control, including combined medical and surgical therapies. All patients showed deterioration of visual acuity after glaucoma onset. The findings highlight the importance of lifelong follow-up for children undergoing congenital cataract surgery, especially those operated at an early age or with systemic comorbidities, and emphasize the need for structured protocols for early glaucoma detection and timely intervention