Glaucoma following cataract surgery in pediatric patients: a systematic review of incidence, risk factors, and management strategies.

Glaucoma following pediatric cataract surgery is a sight-threatening complication with reported incidence rates of 3.3–25.5%, influenced by surgical factors, patient age, and anatomical characteristics. This review synthesizes evidence from 36 studies, identifying younger age at surgery (< 9 months), aphakia, microcornea, and sulcus intraocular lens (IOL) implantation as key risk factors, while in-the-bag IOL placement with posterior optic capture demonstrates the lowest glaucoma risk. A bimodal onset pattern (early postoperative vs. delayed presentation) necessitates lifelong monitoring, particularly in high-risk cases. Surgical management with goniotomy shows efficacy, though heterogeneity in study designs and diagnostic criteria limits consensus. These findings underscore the need for standardized protocols, meticulous surgical techniques, and risk-adapted follow-up. Future research should prioritize prospective, multicenter studies with long-term outcomes to optimize prevention and treatment strategies.