OBJECTIVE: To report the accuracy of intraocular lens (IOL) power calculations and the early refractive status in pseudophakic eyes of infants in the Infant Aphakia Treatment Study. METHODS: Eyes randomized to receive primary IOL implantation were targeted for a postoperative refraction of +8.0 diopters (D) for infants 28 to 48 days old at surgery and +6.0 D for those 49 days or older to younger than 7 months at surgery using the Holladay 1 formula. Refraction 1 month after surgery was converted to spherical equivalent, and prediction error (PE; defined as the calculated refraction minus the actual refraction) and absolute PE were calculated. Baseline eye and surgery characteristics and A-scan quality were analyzed to compare their effect on PE. MAIN OUTCOME MEASURES: Prediction error. RESULTS:Fifty-six eyes underwent primary IOL implantation; 7 were excluded for lack of postoperative refraction (n = 5) or incorrect technique in refraction (n = 1) or biometry (n = 1). Overall mean (SD) absolute PE was 1.8 (1.3) D and mean (SD) PE was +1.0 (2.0) D. Absolute PE was less than 1 D in 41% of eyes but greater than 2 D in 41% of eyes. Mean IOL power implanted was 29.9 D (range, 11.5-40.0 D); most eyes (88%) implanted with an IOL of 30.0 D or greater had less postoperative hyperopia than planned. Multivariate analysis revealed that only short axial length (<18 mm) was significant for higher PE. CONCLUSIONS:Short axial length correlates with higher PE after IOL placement in infants. Less hyperopia than anticipated occurs with axial lengths of less than 18 mm or high-power IOLs. Application to Clinical Practice Quality A-scans are essential and higher PE is common, with a tendency for less hyperopia than expected. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00212134.
RCT Entities:
OBJECTIVE: To report the accuracy of intraocular lens (IOL) power calculations and the early refractive status in pseudophakic eyes of infants in the InfantAphakia Treatment Study. METHODS: Eyes randomized to receive primary IOL implantation were targeted for a postoperative refraction of +8.0 diopters (D) for infants 28 to 48 days old at surgery and +6.0 D for those 49 days or older to younger than 7 months at surgery using the Holladay 1 formula. Refraction 1 month after surgery was converted to spherical equivalent, and prediction error (PE; defined as the calculated refraction minus the actual refraction) and absolute PE were calculated. Baseline eye and surgery characteristics and A-scan quality were analyzed to compare their effect on PE. MAIN OUTCOME MEASURES: Prediction error. RESULTS: Fifty-six eyes underwent primary IOL implantation; 7 were excluded for lack of postoperative refraction (n = 5) or incorrect technique in refraction (n = 1) or biometry (n = 1). Overall mean (SD) absolute PE was 1.8 (1.3) D and mean (SD) PE was +1.0 (2.0) D. Absolute PE was less than 1 D in 41% of eyes but greater than 2 D in 41% of eyes. Mean IOL power implanted was 29.9 D (range, 11.5-40.0 D); most eyes (88%) implanted with an IOL of 30.0 D or greater had less postoperative hyperopia than planned. Multivariate analysis revealed that only short axial length (<18 mm) was significant for higher PE. CONCLUSIONS: Short axial length correlates with higher PE after IOL placement in infants. Less hyperopia than anticipated occurs with axial lengths of less than 18 mm or high-power IOLs. Application to Clinical Practice Quality A-scans are essential and higher PE is common, with a tendency for less hyperopia than expected. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00212134.
Authors: Deborah K Vanderveen; Rupal H Trivedi; Azhar Nizam; Michael J Lynn; Scott R Lambert Journal: Am J Ophthalmol Date: 2013-09-04 Impact factor: 5.258
Authors: Scott R Lambert; Michael J Lynn; E Eugenie Hartmann; Lindreth DuBois; Carolyn Drews-Botsch; Sharon F Freedman; David A Plager; Edward G Buckley; M Edward Wilson Journal: JAMA Ophthalmol Date: 2014-06 Impact factor: 7.389
Authors: David Weakley; George Cotsonis; M Edward Wilson; David A Plager; Edward G Buckley; Scott R Lambert Journal: Am J Ophthalmol Date: 2017-05-17 Impact factor: 5.258
Authors: Michael X Repka; Trevano W Dean; Elizabeth L Lazar; Kimberly G Yen; Phoebe D Lenhart; Sharon F Freedman; Denise Hug; Bahram Rahmani; Serena X Wang; Raymond T Kraker; David K Wallace Journal: Ophthalmology Date: 2016-10-18 Impact factor: 12.079
Authors: Donald O Mutti; Loraine T Sinnott; G Lynn Mitchell; Lisa A Jordan; Nina E Friedman; Sara L Frane; Wendy K Lin Journal: Optom Vis Sci Date: 2018-11 Impact factor: 1.973
Authors: Deborah K VanderVeen; Carolyn D Drews-Botsch; Azhar Nizam; Erick D Bothun; Lorri B Wilson; M Edward Wilson; Scott R Lambert Journal: J Cataract Refract Surg Date: 2021-02-01 Impact factor: 3.528