Intraocular pressure elevation during early postoperative period after secondary intraocular lens implantation in children and adolescents.

PURPOSE: To look at the intraocular pressure (IOP) spike in the early postoperative period after secondary intraocular lens (IOL) implantation in children. SETTING: Miles Center for Pediatric Ophthalmology, Medical University of South Carolina, South Carolina, USA. DESIGN: Retrospective chart review. METHODS: The postoperative day-1 examination of patients having secondary IOL implantation by the same surgeon was reviewed for an IOP greater than 26 mm Hg. In patients with an IOP spike, the medical history and examination findings that might be associated with the rise were evaluated. RESULTS: Review of 85 patient charts (133 eyes) identified 9 eyes that developed an IOP spike during the early postoperative period. Six eyes were symptomatic, with symptoms including pain, ocular discomfort, nausea, and emesis, and 6 eyes had preoperative aphakic glaucoma, which was controlled with medication. Six of 22 eyes (27%) with preoperative aphakic glaucoma and 3 of 111 eyes (3%) without glaucoma (P<.001) developed an acute IOP rise (relative risk, 10.1). CONCLUSIONS: The high incidence of a symptomatic early IOP spike in patients with aphakic glaucoma warrants meticulous ophthalmic viscosurgical device removal at the end of surgery, consideration of the routine use of prophylactic topical and/or systemic glaucoma medication, and monitoring during the early postoperative period.

Age and racial variation in central corneal thickness of preschool and school-aged children.

PURPOSE: The purpose of this study was to determine variations in central corneal thickness (CCT) of preschool and school-aged African American and white children. Secondary aims were to assess possible correlations between CCT measurements and gender, axial length, intraocular pressure (IOP), family history of glaucoma, or history of prematurity. METHODS: Contact ultrasound was used to measure CCT and axial length in 76 white and 60 African American children between the ages of 7 months and 18 years. A questionnaire was completed by the parents or guardians, including medical and family history. Statistically significant associations and differences were assessed using the independent t test, analysis of variance, and linear regression. All associations were defined as significant when the alpha value was less than 0.05 (two-tailed). RESULTS: Mean CCT was thinner in African American children (535 +/- 35 microm) compared to white children (559 +/- 38 microm) (P < .001). The corneal thickness in children ages 10 to 18 years was significantly higher than in all other age groups in both African American (P = .03) and white (P < .005) children. No association was found between CCT and gender, axial length, IOP, or family history of glaucoma. Premature children had thinner CCT (536 +/- 40 pm) than full-term children (552 +/- 38 microm) (P = .009). CONCLUSIONS: African American children have a thinner CCT compared to white children at all ages. Children of both racial groups have an increasing value of CCT with increasing age after approximately age 10 years. Children born prematurely have a thinner CCT than full-term children.