To determine the incidence of glaucoma following bilateral congenital cataract removal and estimate the associated risk factors in a large cohort to provide guidance for clinical practice.

A prospective longitudinal cohort study of pediatric patients who underwent surgery for congenital/infantile cataracts between January 2011 and December 2025 was performed.

Inclusion Criteria:

• a diagnosis of bilateral congenital cataracts, the etiologies include congenital idiopathic cataract and congenital cataract associated with a systemic syndrome or ocular anomalies;
• cataract surgery performed in ZOC;
• age at cataract removal younger than 16 years;

Exclusion Criteria:

• the preoperative IOP was above 21 mm Hg;
• family history of glaucoma;
• signs of preoperative glaucoma were present, such as corneal clouding, corneal enlargement, excessive cup-disc ratio and myopic shift;
• ocular trauma history;
• previous surgery intervention and
• they were noncompliant with our follow-up protocol to monitor the occurrence of glaucoma and glaucoma suspect.

A prospective longitudinal cohort study of pediatric patients who underwent surgery for congenital cataracts was performed.