Insights and decision-making on surgical triggers of glaucoma-related complications in congenital cataract surgery: a clinical review.

Glaucoma-related adverse events (GRAE) after congenital cataract surgery severely affect the visual recovery of children and have attracted significant attention in the medical community. This article focuses on the research of its surgical factors. In terms of age, the younger the age at surgery, the higher the risk of glaucoma-related adverse events after surgery. Regarding surgical methods, primary in-the-bag intraocular lens (IOL) implantation, secondary in-the-bag IOL implantation, and ciliary sulcus IOL implantation have different effects on the incidence of glaucoma. There are controversies over the advantages and disadvantages of different implantation methods and the definition of high-risk factors. In terms of medications, corticosteroids used to control inflammation may induce elevated intraocular pressure, and the safety data of intraocular pressure-lowering medications in children are incomplete. To balance the contradictions among surgical methods, surgical timing, and medication use, it is necessary to closely monitor the intraocular pressure, anterior segment structure, and the space of the posterior segment during the perioperative period. When the intraocular pressure rises, the cause should be identified clearly and targeted treatment should be carried out. When using medications to lower intraocular pressure, drugs with fewer adverse reactions in children should be preferred. Minimally invasive glaucoma surgery (MIGS) is a promising option for refractory cases. Further research is needed in the future to clarify the risk factors, optimize treatment strategies, reduce the incidence of glaucoma-related adverse events after congenital cataract surgery, and improve the visual prognosis of children.