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Strabismus surgery outcomes in the Infant Aphakia Treatment Study (IATS) at age 5 years.

ABSTRACT: To report strabismus surgery frequency and outcomes after monocular infantile cataract surgery with or without IOL implantation.The Infant Aphakia Treatment Study (IATS) is a randomized, multicenter clinical trial comparing treatment of aphakia with a primary IOL or contact lens in 114 infants with a unilateral congenital cataract. This report is a secondary outcome analysis of ocular motor data from IATS patients who underwent strabismus surgery prior to age 5 years.Strabismus surgery was performed in 45 (39%) patients (contact lens group [CL], 37%; IOL group, 42% [P = 0.70]). The indications for strabismus surgery were esotropia (62%), exotropia (33%), and hypertropia (4%). Infants who underwent cataract surgery at a younger age were less likely to undergo strabismus surgery (28-48 days, 12/50 [24%]; 49-210 days, 33/64 [52%]; P = 0.0037). Of the 42 patients who underwent strabismus surgery, 14 (33%) had a postoperative distance alignment within 8? of orthotropia at age 5 years. The 5-year visual acuity of children with strabismus was the same whether or not strabismus surgery had been performed (1.10 logMAR with surgery vs 1.00 without [P = 0.71]).In this study cohort, cataract surgery performed in the first 6 weeks of life was associated with a reduced frequency of strabismus surgery. Strabismus surgery outcomes in this population are guarded. Surgical improvement of strabismus does not appear to influence long-term visual acuity.

SUBMITTER: Bothun ED

PROVIDER: S-EPMC5344799 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Strabismus surgery outcomes in the Infant Aphakia Treatment Study (IATS) at age 5 years.

Bothun Erick D ED Lynn Michael J MJ Christiansen Stephen P SP Kruger Stacey J SJ Vanderveen Deborah K DK Neely Dan E DE Lambert Scott R SR

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus 20161102 6

<h4>Purpose</h4>To report strabismus surgery frequency and outcomes after monocular infantile cataract surgery with or without IOL implantation.<h4>Methods</h4>The Infant Aphakia Treatment Study (IATS) is a randomized, multicenter clinical trial comparing treatment of aphakia with a primary IOL or contact lens in 114 infants with a unilateral congenital cataract. This report is a secondary outcome analysis of ocular motor data from IATS patients who underwent strabismus surgery prior to age 5 ye ...[more]

PMID: 27815186

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Project description:PurposeTo report the longitudinal change in axial length (AL) from the time of unilateral cataract surgery at age 1 to 7 months to age 5 years, and to compare AL growth of operated eyes with that of fellow unoperated eyes.DesignComparative case series.ParticipantsInfants enrolled in the Infant Aphakia Treatment Study (IATS).MethodsThe AL at baseline and age 5 years and change in AL were analyzed relative to treated versus fellow eye, visual outcome, and treatment modality (contact lens [CL] vs. intraocular lens [IOL]). Eyes with glaucoma or glaucoma suspect were excluded from primary analysis but reported separately.Main outcome measuresThe AL growth from preoperative to age 5 years.ResultsSeventy patients were eligible; however, AL data for both eyes were available for 64 patients at baseline and 69 patients at age 5 years. The AL was significantly different between treated and fellow eyes preoperatively (18.1 vs. 18.7 mm, P < 0.0001) and at the final follow-up (21.4 vs. 22.1 mm, P = 0.0004). The difference in AL growth between treated and fellow eyes was not significant (3.3 vs. 3.5 mm, P = 0.31). The change in AL in eyes was similar with both treatments (CL 3.2 mm and IOL 3.4 mm, P = 0.53) and did not correlate with visual outcomes (P = 0.85). Eyes receiving additional surgery to clear the visual axis opacification grew significantly more compared with eyes not receiving surgery to clear the visual axis (3.8 vs. 2.7 mm, P = 0.013). Patients with glaucoma showed significantly more eye growth (5.7 mm) than those without glaucoma (3.3 mm) and glaucoma suspects (4.3 mm).ConclusionsEyes treated for monocular cataract in infancy have axial growth similar to that of fellow eyes, despite having a shorter AL at the time of surgery. The change in AL in eyes was similar with both treatments (CL and IOL), did not correlate with visual outcomes, and was higher in eyes receiving additional surgery to clear the visual axis or eyes diagnosed with glaucoma.

Dataset Information

Strabismus surgery outcomes in the Infant Aphakia Treatment Study (IATS) at age 5 years.

Publications

Strabismus surgery outcomes in the Infant Aphakia Treatment Study (IATS) at age 5 years.

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