A comparison of grating visual acuity, strabismus, and reoperation outcomes among children with aphakia and pseudophakia after unilateral cataract surgery during the first six months of life

Scott R. Lambert, Michael Lynn, Carolyn Drews-Botsch, Donna Loupe, David Plager, Norman B. Medow, M. Edward Wilson, Edward G. Buckley, Arlene V. Drack, Sherry L. Fawcett

Research output: Contribution to journalArticle

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Abstract

Purpose: The method of correcting aphakia after unilateral cataract extraction during infancy is controversial. Some authorities advocate correction with an intraocular lens (IOL) whereas others advocate correction with a contact lens (CL). We compared grating visual acuity, alignment, and reoperative outcomes in age-matched children treated with these 2 modalities at 5 clinical centers. Methods: Twenty-five infants born in 1997 or 1998 with a dense unilateral congenital cataract who had cataract surgery coupled with (IOL group, n = 12) or without (CL group, n = 13) primary IOL implantation were enrolled in this study. All patients were prescribed half-time occlusion therapy. In July 1999, their grating visual acuities, ocular alignments, and reoperation rates were assessed. Results: The mean grating visual acuity (LogMAR) for the affected eye was 0.70±0.32 for the IOL group and 0.87±0.31 for the CL group (P =.19). The mean interocular difference in grating visual acuity was 0.26±0.30 for the IOL group and 0.50±0.28 for the CL group (P = .048). The incidence of strabismus (>10 PD) was 75% in the IOL group compared with 92% in the CL group (P= .24). The incidence of reoperations was 83% in the IOL group compared with 23% in the CL group (P= .003). Conclusions: Our preliminary data suggest that correcting aphakia after unilateral congenital cataract surgery with primary IOL implantation results in an improved visual outcome but a higher rate of complications requiring reoperation. A randomized clinical trial, the Infant Aphakia Treatment Study, is planned to further study the optimal treatment for aphakia following unilateral cataract extraction during infancy.

Original languageEnglish
Pages (from-to)70-75
Number of pages6
JournalJournal of AAPOS
Volume5
Issue number2
DOIs
StatePublished - Apr 2001

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Pseudophakia
Aphakia
Intraocular Lenses
Strabismus
Contact Lenses
Reoperation
Cataract
Visual Acuity
Intraocular Lens Implantation
Cataract Extraction
Incidence
Therapeutics
Randomized Controlled Trials

ASJC Scopus subject areas

  • Ophthalmology

Cite this

A comparison of grating visual acuity, strabismus, and reoperation outcomes among children with aphakia and pseudophakia after unilateral cataract surgery during the first six months of life. / Lambert, Scott R.; Lynn, Michael; Drews-Botsch, Carolyn; Loupe, Donna; Plager, David; Medow, Norman B.; Wilson, M. Edward; Buckley, Edward G.; Drack, Arlene V.; Fawcett, Sherry L.

In: Journal of AAPOS, Vol. 5, No. 2, 04.2001, p. 70-75.

Research output: Contribution to journalArticle

Lambert, Scott R. ; Lynn, Michael ; Drews-Botsch, Carolyn ; Loupe, Donna ; Plager, David ; Medow, Norman B. ; Wilson, M. Edward ; Buckley, Edward G. ; Drack, Arlene V. ; Fawcett, Sherry L. / A comparison of grating visual acuity, strabismus, and reoperation outcomes among children with aphakia and pseudophakia after unilateral cataract surgery during the first six months of life. In: Journal of AAPOS. 2001 ; Vol. 5, No. 2. pp. 70-75.
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abstract = "Purpose: The method of correcting aphakia after unilateral cataract extraction during infancy is controversial. Some authorities advocate correction with an intraocular lens (IOL) whereas others advocate correction with a contact lens (CL). We compared grating visual acuity, alignment, and reoperative outcomes in age-matched children treated with these 2 modalities at 5 clinical centers. Methods: Twenty-five infants born in 1997 or 1998 with a dense unilateral congenital cataract who had cataract surgery coupled with (IOL group, n = 12) or without (CL group, n = 13) primary IOL implantation were enrolled in this study. All patients were prescribed half-time occlusion therapy. In July 1999, their grating visual acuities, ocular alignments, and reoperation rates were assessed. Results: The mean grating visual acuity (LogMAR) for the affected eye was 0.70±0.32 for the IOL group and 0.87±0.31 for the CL group (P =.19). The mean interocular difference in grating visual acuity was 0.26±0.30 for the IOL group and 0.50±0.28 for the CL group (P = .048). The incidence of strabismus (>10 PD) was 75{\%} in the IOL group compared with 92{\%} in the CL group (P= .24). The incidence of reoperations was 83{\%} in the IOL group compared with 23{\%} in the CL group (P= .003). Conclusions: Our preliminary data suggest that correcting aphakia after unilateral congenital cataract surgery with primary IOL implantation results in an improved visual outcome but a higher rate of complications requiring reoperation. A randomized clinical trial, the Infant Aphakia Treatment Study, is planned to further study the optimal treatment for aphakia following unilateral cataract extraction during infancy.",
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T1 - A comparison of grating visual acuity, strabismus, and reoperation outcomes among children with aphakia and pseudophakia after unilateral cataract surgery during the first six months of life

AU - Lambert, Scott R.

AU - Lynn, Michael

AU - Drews-Botsch, Carolyn

AU - Loupe, Donna

AU - Plager, David

AU - Medow, Norman B.

AU - Wilson, M. Edward

AU - Buckley, Edward G.

AU - Drack, Arlene V.

AU - Fawcett, Sherry L.

PY - 2001/4

Y1 - 2001/4

N2 - Purpose: The method of correcting aphakia after unilateral cataract extraction during infancy is controversial. Some authorities advocate correction with an intraocular lens (IOL) whereas others advocate correction with a contact lens (CL). We compared grating visual acuity, alignment, and reoperative outcomes in age-matched children treated with these 2 modalities at 5 clinical centers. Methods: Twenty-five infants born in 1997 or 1998 with a dense unilateral congenital cataract who had cataract surgery coupled with (IOL group, n = 12) or without (CL group, n = 13) primary IOL implantation were enrolled in this study. All patients were prescribed half-time occlusion therapy. In July 1999, their grating visual acuities, ocular alignments, and reoperation rates were assessed. Results: The mean grating visual acuity (LogMAR) for the affected eye was 0.70±0.32 for the IOL group and 0.87±0.31 for the CL group (P =.19). The mean interocular difference in grating visual acuity was 0.26±0.30 for the IOL group and 0.50±0.28 for the CL group (P = .048). The incidence of strabismus (>10 PD) was 75% in the IOL group compared with 92% in the CL group (P= .24). The incidence of reoperations was 83% in the IOL group compared with 23% in the CL group (P= .003). Conclusions: Our preliminary data suggest that correcting aphakia after unilateral congenital cataract surgery with primary IOL implantation results in an improved visual outcome but a higher rate of complications requiring reoperation. A randomized clinical trial, the Infant Aphakia Treatment Study, is planned to further study the optimal treatment for aphakia following unilateral cataract extraction during infancy.

AB - Purpose: The method of correcting aphakia after unilateral cataract extraction during infancy is controversial. Some authorities advocate correction with an intraocular lens (IOL) whereas others advocate correction with a contact lens (CL). We compared grating visual acuity, alignment, and reoperative outcomes in age-matched children treated with these 2 modalities at 5 clinical centers. Methods: Twenty-five infants born in 1997 or 1998 with a dense unilateral congenital cataract who had cataract surgery coupled with (IOL group, n = 12) or without (CL group, n = 13) primary IOL implantation were enrolled in this study. All patients were prescribed half-time occlusion therapy. In July 1999, their grating visual acuities, ocular alignments, and reoperation rates were assessed. Results: The mean grating visual acuity (LogMAR) for the affected eye was 0.70±0.32 for the IOL group and 0.87±0.31 for the CL group (P =.19). The mean interocular difference in grating visual acuity was 0.26±0.30 for the IOL group and 0.50±0.28 for the CL group (P = .048). The incidence of strabismus (>10 PD) was 75% in the IOL group compared with 92% in the CL group (P= .24). The incidence of reoperations was 83% in the IOL group compared with 23% in the CL group (P= .003). Conclusions: Our preliminary data suggest that correcting aphakia after unilateral congenital cataract surgery with primary IOL implantation results in an improved visual outcome but a higher rate of complications requiring reoperation. A randomized clinical trial, the Infant Aphakia Treatment Study, is planned to further study the optimal treatment for aphakia following unilateral cataract extraction during infancy.

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