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Purpose <p>To evaluate the efficacy and safety of goniotomy with or without secondary intraocular lens implantation in eyes with pediatric glaucoma following cataract surgery (GFCS) over a 2-year follow-up period.</p> Methods <p>The study prospectively included 34 eyes of 24 pediatric patients diagnosed with GFCS who underwent either standalone goniotomy or goniotomy combined with secondary IOL implantation. Clinical data including demographics, preoperative characteristics, intraoperative procedures, and postoperative outcomes were collected over a 2-year follow-up. The primary outcome was surgical success, defined as either complete success (intraocular pressure [IOP] ≤ 21 mmHg without anti-glaucoma medications and ≥ 20% reduction) or qualified success (IOP ≤ 21 mmHg and ≥ 20% reduction with or without medications).</p> Results <p>After a 2-year follow-up, the complete success rate was 47.1% (16 of 34), and the qualified success rate was 85.3% (29 of 34). The main complications included postoperative IOP spike and hyphema, occurring in 55.9% (19 of 34) and 29.4% (10 of 34) of eyes, respectively. No vision-threatening complications were observed. Multivariate analysis showed that older age at goniotomy, preoperative angle closure, higher baseline IOP, and absence of postoperative IOP spike were independently associated with a higher likelihood of complete success (all <i>P</i> &lt; 0.05).</p> Conclusion <p>Goniotomy with or without secondary IOL implantation proves to be an effective and safe treatment for pediatric GFCS, providing sustained IOP control and medication reduction over 2 years. Older age at goniotomy, angle closure, higher preoperative IOP, and absence of postoperative IOP spike were associated with higher complete success rates.</p>

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Two-year outcomes after goniotomy with or without secondary intraocular lens implantation in pediatric glaucoma following cataract surgery: a prospective cohort study

  • 期刊论文

  • 发表日期：

    2026年2月20日

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  • Kun Hu,
  • Yu Zhang,
  • Wan Chen,
  • Ling Jin,
  • Xin Li,
  • Tingfeng Qin,
  • Miner Huang,
  • Xiulan Zhang,
  • Weirong Chen

摘要

Purpose

To evaluate the efficacy and safety of goniotomy with or without secondary intraocular lens implantation in eyes with pediatric glaucoma following cataract surgery (GFCS) over a 2-year follow-up period.

Methods

The study prospectively included 34 eyes of 24 pediatric patients diagnosed with GFCS who underwent either standalone goniotomy or goniotomy combined with secondary IOL implantation. Clinical data including demographics, preoperative characteristics, intraoperative procedures, and postoperative outcomes were collected over a 2-year follow-up. The primary outcome was surgical success, defined as either complete success (intraocular pressure [IOP] ≤ 21 mmHg without anti-glaucoma medications and ≥ 20% reduction) or qualified success (IOP ≤ 21 mmHg and ≥ 20% reduction with or without medications).

Results

After a 2-year follow-up, the complete success rate was 47.1% (16 of 34), and the qualified success rate was 85.3% (29 of 34). The main complications included postoperative IOP spike and hyphema, occurring in 55.9% (19 of 34) and 29.4% (10 of 34) of eyes, respectively. No vision-threatening complications were observed. Multivariate analysis showed that older age at goniotomy, preoperative angle closure, higher baseline IOP, and absence of postoperative IOP spike were independently associated with a higher likelihood of complete success (all P < 0.05).

Conclusion

Goniotomy with or without secondary IOL implantation proves to be an effective and safe treatment for pediatric GFCS, providing sustained IOP control and medication reduction over 2 years. Older age at goniotomy, angle closure, higher preoperative IOP, and absence of postoperative IOP spike were associated with higher complete success rates.