David A Plager1, Michael J Lynn2, Edward G Buckley3, M Edward Wilson4, Scott R Lambert2. 1. Indiana University Medical Center, Indianapolis, Indiana. Electronic address: dplager@iu.edu. 2. Emory University, Atlanta, Georgia. 3. Duke University, Durham, North Carolina. 4. Medical University of South Carolina, Charleston, South Carolina.
Abstract
PURPOSE: To compare rates and severity of complications between infants undergoingcataract surgery with and without intraocular lens (IOL) implantation. DESIGN: Prospective randomized clinical trial. METHODS: A total of 114 infants were enrolled in the Infant Aphakia Treatment Study, a randomized, multi-center (12) clinical trial comparing the treatment of unilateral aphakia in patients under 7 months of age with a primary IOL implant or contact lens. The rate, character, and severity of intraoperative complications, adverse events, and additional intraocular surgeries during the first 5 postoperative years in the 2 groups were examined. RESULTS: There were more patients with intraoperative complications (28% vs 11%, P = .031), adverse events (81% vs 56%, P = .008), and more additional intraocular surgeries (72% vs 16%, P < .0001) in the IOL group than in the contact lens group. However, the number of patients with adverse events in the contact lens group increased (15 to 24) in postoperative years 2-5 compared to the first postoperative year, while it decreased (44 to 14) in years 2-5 compared to the first postoperative year in the IOL group. If only one half of the patients in the contact lens (aphakic) group eventually undergo secondary IOL implantation, the number of additional intraocular surgeries in the 2 groups will be approximately equal. CONCLUSION: The increased rate of complications, adverse events, and additional intraocular surgeries associated with IOL implantation in infants <7 months of age militates toward leaving babies aphakic if it is considered likely that the family will be successful with contact lens correction.
RCT Entities:
PURPOSE: To compare rates and severity of complications between infants undergoing cataract surgery with and without intraocular lens (IOL) implantation. DESIGN: Prospective randomized clinical trial. METHODS: A total of 114 infants were enrolled in the InfantAphakia Treatment Study, a randomized, multi-center (12) clinical trial comparing the treatment of unilateral aphakia in patients under 7 months of age with a primary IOL implant or contact lens. The rate, character, and severity of intraoperative complications, adverse events, and additional intraocular surgeries during the first 5 postoperative years in the 2 groups were examined. RESULTS: There were more patients with intraoperative complications (28% vs 11%, P = .031), adverse events (81% vs 56%, P = .008), and more additional intraocular surgeries (72% vs 16%, P < .0001) in the IOL group than in the contact lens group. However, the number of patients with adverse events in the contact lens group increased (15 to 24) in postoperative years 2-5 compared to the first postoperative year, while it decreased (44 to 14) in years 2-5 compared to the first postoperative year in the IOL group. If only one half of the patients in the contact lens (aphakic) group eventually undergo secondary IOL implantation, the number of additional intraocular surgeries in the 2 groups will be approximately equal. CONCLUSION: The increased rate of complications, adverse events, and additional intraocular surgeries associated with IOL implantation in infants <7 months of age militates toward leaving babies aphakic if it is considered likely that the family will be successful with contact lens correction.
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: S R Lambert; M Lynn; C Drews-Botsch; D Loupe; D A Plager; N B Medow; M E Wilson; E G Buckley; A V Drack; S L Fawcett Journal: J AAPOS Date: 2001-04 Impact factor: 1.220
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 A Plager; Michael J Lynn; Edward G Buckley; M Edward Wilson; Scott R Lambert Journal: Ophthalmology Date: 2011-09-16 Impact factor: 12.079
Authors: Scott R Lambert; Michael J Lynn; Lindreth G DuBois; George A Cotsonis; E Eugenie Hartmann; M Edward Wilson Journal: Invest Ophthalmol Vis Sci Date: 2012-11-07 Impact factor: 4.799
Authors: Erick D Bothun; Michael J Lynn; Stephen P Christiansen; Dan E Neely; Deborah K Vanderveen; Stacey J Kruger; Scott R Lambert Journal: J AAPOS Date: 2016-02 Impact factor: 1.220
Authors: Sharon F Freedman; Michael J Lynn; Allen D Beck; Erick D Bothun; Faruk H Örge; Scott R Lambert Journal: JAMA Ophthalmol Date: 2015-08 Impact factor: 7.389