Research published in Acta Ophthalmologica indicates that administering low glucocorticoid doses after pediatric cataract surgery may lower the risk of glaucoma in certain patients. Specifically, children with axial lengths of at least 18 mm showed a reduced long-term risk of glaucoma when treated with low glucocorticoid doses compared to high-dose treatments.
The study, conducted in Denmark, analyzed data from 267 patients (95 on high-dose treatment with a median follow-up of 89 months and 173 on low-dose treatment with a median follow-up of 40.5 months) who underwent cataract surgery between 2010 and 2021, all of whom were under 10 years old. Patients received either high-dose glucocorticoids (dexamethasone or methylprednisolone acetate) or a low-dose regimen of dexamethasone drops.
Findings revealed that by two years post-surgery, about 10% of the high-dose group experienced glaucoma or ocular hypertension (OHT), compared to just 1% in the low-dose group. This difference diminished by the six-year mark. Additionally, 57 participants underwent treatment for visual axis opacification.
Notably, children with axial lengths of at least 18 mm were less likely to develop glaucoma or OHT with low-dose treatment. Younger patients, particularly those under six months at surgery, faced a greater risk, possibly due to age-related ocular anomalies affecting the trabecular meshwork.
The researchers caution that the study may have limitations, including potential selection and confounding biases.
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