Aphakic glaucoma is the most common long-term complication seen following congenital cataract surgery. It has \na reported incidence of between 15% and 45%. Many risk factors have been identified including microcornea, early \nsurgery, persistent fetal vasculature, congenital rubella syndrome, Lowe syndrome, chronic inflammation and retained \nlens material. Diagnosis is often difficult as the classic signs of congenital glaucoma such as epiphora, blepharospasm \nand buphthalmos are usually absent. Additionally, it is also difficult to perform accurate ocular examinations on \nyoung children and examination under anaesthesia is usually required. Surgical intervention is often required with \nmedical treatment providing adjunctive therapy. Surgical techniques performed include trabeculectomy with or without \nantifibrotic agents, glaucoma drainage devices (valved and non-valved), cyclodestructive procedures, goniotomy \nand trabeculotomy. Trabeculectomy with mitomycin C and glaucoma drainage devices are the two most commonly \nperformed procedures. In spite of considerable advances having been made in the management of aphakic glaucoma, \nit still poses a significant management dilemma. Despite best standard of care two thirds of aphakic children end up \nwith a mean visual acuity of = 20/400.
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