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

S R Lambert; M Lynn; C Drews-Botsch; D Loupe; D A Plager; N B Medow; M Edward Wilson; Edward G Buckley; A V Drack; S L Fawcett

doi:10.1067/mpa.2001.111015

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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

Journal article

Peer reviewed

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

S R Lambert, M Lynn, C Drews-Botsch, D Loupe, D A Plager, N B Medow, M Edward Wilson, Edward G Buckley, A V Drack and S L Fawcett

Journal of AAPOS, Vol.5(2), pp.70-75

04/2001

DOI: 10.1067/mpa.2001.111015

PMID: 11304812

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Abstract

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. 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. 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). 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.

Strabismus - physiopathology

Reoperation

Strabismus - etiology

Pseudophakia - therapy

Sensory Deprivation

Cataract Extraction

Humans

Infant

Treatment Outcome

Incidence

Pseudophakia - physiopathology

Contact Lenses

Cataract - congenital

Aphakia, Postcataract - therapy

Lens Implantation, Intraocular

Visual Acuity - physiology

Aphakia, Postcataract - physiopathology

Details

Title: Subtitle: 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
Creators: S R Lambert - Emory Eye Center, Atlanta, Georgia 30322, USA
M Lynn
C Drews-Botsch
D Loupe
D A Plager
N B Medow
M Edward Wilson
Edward G Buckley
A V Drack
S L Fawcett
Resource Type: Journal article
Publication Details: Journal of AAPOS, Vol.5(2), pp.70-75
DOI: 10.1067/mpa.2001.111015
PMID: 11304812
NLM abbreviation: J AAPOS
ISSN: 1091-8531
eISSN: 1528-3933
Publisher: Elsevier Inc; United States
Grant note: R21 EY11987 / NEI NIH HHS
Language: English
Date published: 04/2001
Academic Unit: Stead Family Department of Pediatrics; Ophthalmology and Visual Sciences
Record Identifier: 9983980035402771

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