Cataract formation after initial trabeculectomy in young patients

Objective: To evaluate the risk of cataract formation in young patients after initial trabeculectomy. Design: Retrospective, noncomparative case series. Participants: Thirty-four eyes from 27 patients undergoing initial trabeculectomy at the Glaucoma Consultation Service, Massachusetts Eye and Ear Infirmary (mean age, 43.7 years; range, 12-54 years). Intervention: Follow-up averaged 42.6 months (range, 11-90 months). Methods: Lens status was observed before surgery and at 3 months; 6 months; and 1, 2, 3, 4, 5, and 6 years after initial trabeculectomy. Main Outcome Measure: The main outcome measure was defined as cataract extraction for visually significant lenticular opacifications that developed after trabeculectomy. Results: The rate of cataract extraction after initial trabeculectomy was 24% (n = 8). The average time from trabeculectomy to cataract extraction was 26 months (range, 5-58 months). Progression of lenticular opacities occurred throughout the follow-up period. There was no increased rate of cataract formation in subjects with uveitic and steroid-induced glaucoma when compared with all other types of glaucoma. In the patients with both eyes in the study, the first eye was a predictor of cataract progression in the fellow eye. Conclusions: Cataract is a common complication after trabeculectomy in young patients. The 24% rate of cataract extraction after trabeculectomy reported in this study is a significant risk of which young patients contemplating surgery should be aware.