Schmidt, Diana Chabané;
Martinussen, Torben;
Solebo, Ameenat Lola;
Larsen, Dorte Ancher;
Bach‐Holm, Daniella;
Kessel, Line;
(2024)
Comparing glaucoma risk in children receiving low‐dose and high‐dose glucocorticoid treatment after cataract surgery.
Acta Ophthalmologica
10.1111/aos.16746.
(In press).
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Abstract
Purpose: Treatment with glucocorticoids following paediatric cataract surgery is crucial to prevent inflammation, but may lead to secondary glaucoma, and hypothalamic–pituitary–adrenal axis suppression. We wish to compare glaucoma outcomes following high‐dose and low‐dose glucocorticoid treatment after paediatric cataract surgery. Methods: This cohort study included Danish children undergoing cataract surgery before 10 years of age, receiving either a low‐dose or high‐dose postoperative glucocorticoid treatment. Case identification and collection of a standardized dataset were retrospective, from 1 January 2010 to 31 December 2016, and prospective thereafter, until 31 December 2021. High‐dose treatment included 0.5–1.0 mg subconjunctival depot dexamethasone or methylprednisolone, followed by 6–8 drops of dexamethasone for 1 week, tapered by one drop weekly. Low‐dose treatment included 6 drops for 3 days, followed by 3 drops for 18 days. Sustained (>3 months) ocular hypertension or glaucoma was compared between the two groups. Results: Overall, 267 children (388 eyes) were included in the study. Ninety‐five children (133 eyes) had received high‐dose treatment and had a median follow‐up time of 89 months (IQR: 57.2–107.4), while 173 children (255 eyes) had received the low‐dose treatment and had a median follow‐up time of 40.5 months (IQR: 22.9–60.4). Survival curves showed a lower risk of glaucoma in the low‐dose group for children with axial lengths ≥18 mm. Conclusion: Low‐dose glucocorticoid treatment was associated with a lower risk of glaucoma in children with axial lengths ≥18 mm. The same effect was not observed in children with shorter eyes. High‐dose glucocorticoid should be limited in children undergoing cataract surgery.
| Type: | Article |
|---|---|
| Title: | Comparing glaucoma risk in children receiving low‐dose and high‐dose glucocorticoid treatment after cataract surgery |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/aos.16746 |
| Publisher version: | http://dx.doi.org/10.1111/aos.16746 |
| Language: | English |
| Additional information: | © 2024 The Author(s). Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | congenital cataract, glaucoma, glucocorticoid, ocular hypertension, paediatric cataract, secondary glaucoma, steroid |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10195832 |
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