![]() ![]() 7, 8 However, the sensitive period for visual development, particularly in eyes affected by congenital cataracts, can extend beyond age 4.5 years. 6 The IATS previously reported that grating acuities at age 12 months and HOTV acuity testing system results at age 4.5 years were similar for children randomized to receive an IOL at the time of cataract extraction compared with those who did not receive an IOL. Quiz Ref ID The Infant Aphakia Treatment Study (IATS) is a multicenter randomized clinical trial comparing visual outcomes following cataract surgery with or without IOL implantation in infants aged 1 to 6 months with a unilateral congenital cataract. However, there is a general reluctance to implant IOLs in young children because their eyes can develop large refractive errors later in childhood and they have a higher risk of developing visual axis opacities after IOL implantation. 1 - 3 Compared with aphakic contact lenses and eyeglasses, IOLs have the advantage that partial optical correction is worn at all times. Intraocular lenses (IOLs) are being used increasingly to focus eyes in children after cataract surgery. Trial Registration Identifier: NCT00212134 Implanting an IOL at the time of cataract extraction was neither beneficial nor detrimental to the visual outcome. Although the overall difference in median visual acuity between the 2 groups was small, the estimate was imprecise (99% CI for the difference in medians was −0.54 to 0.47).Ĭonclusions and Relevance As in previous phases of the study, visual acuity outcomes were highly variable with only 27 children (25%) achieving excellent visual acuity in their treated eye and 50 children (44%) having poor vision in the treated eye. The median logMAR acuity in the treated eye was similar in children randomized to receive an IOL at the time of cataract extraction (0.89 interquartile range, 0.33-1.43 ) and those who remained aphakic (0.86 IQR, 0.30-1.46 ) (IQR, 0.30-1.46 P = .82). Overall, 27 of the children (25%) had good (logMAR 0.30 or better) visual acuity in the treated eye (12 in the IOL group and 15 in the aphakia group), but 50 children (44%) had a visual acuity of logMAR 1.00 (Snellen equivalent, 20/200) or worse (25 in the IOL group and 25 in the aphakia group). The participants included 58 girls (53%) and 52 boys (47%). Results Best-corrected visual acuity was measured at age 10.5 years for 110 of the 114 patients (96%) enrolled as infants. Analysis was performed on an intention-to-treat basis. ![]() Main Outcomes and Measures Best-corrected visual acuity using the electronic Early Treatment Diabetic Retinopathy Study (E-ETDRS) testing protocol. Interventions Intraocular lens implantation at the time of cataract surgery. ![]() Data on long-term visual outcomes were collected when the children were age 10.5 years (July 14, 2015, to July 12, 2019) and analyzed from March 30 through August 6, 2019. Objective To compare long-term visual outcomes with contact lens vs IOL correction following unilateral cataract surgery during infancy.ĭesign, Setting, and Participants This multicenter randomized clinical trial enrolled 114 infants with a unilateral congenital cataract who underwent cataract surgery with or without primary IOL implantation between 1 and 6 months of age. Importance Although intraocular lenses (IOLs) are often implanted in children, little is known whether primary IOL implantation or aphakia and contact lens correction results in better long-term visual outcomes after unilateral cataract surgery during infancy.
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