Palak B Wall1, Jason A Lee2, Michael J Lynn2, Scott R Lambert3, Elias I Traboulsi4. 1. Department of Pediatric Ophthalmology and Strabismus, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Electronic address: palak.wall@gmail.com. 2. Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia. 3. Department of Ophthalmology, Emory University School of Medicine, Atlanta, and School of Public Health, Emory University School of Medicine, Atlanta. 4. Department of Pediatric Ophthalmology and Strabismus, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
Abstract
PURPOSE: To evaluate the effect of surgical factors on postoperative astigmatism in infants undergoing cataract extraction with or without intraocular lens (IOL) implantation. METHODS: The Infant Aphakia Treatment Study is a multicenter clinical trial in which 114 infants with unilateral congenital cataracts were randomized to undergo cataract extraction with IOL placement or contact lens aphakic correction. Surgical videos were reviewed with regard to incision type and location, whether the incision was extended, the number of sutures placed, and technique of closure. Corneal astigmatism was measured using a handheld keratometer prior to surgery and at 1 year of age. RESULTS:Corneal astigmatism decreased from a mean of 1.92 D at baseline to 1.62 D at age 1 year in the contact lens group but remained almost unchanged from 2.00 D to 2.09 D in the IOL group (P = 0.023). There was no statistical difference between the amount of corneal astigmatism with regard to incision type (P = 0.214) and no increase in astigmatism with extension of the incision to facilitate IOL placement (P = 0.849) at 1 year. The number of sutures and technique of closure did not influence the amount of astigmatism at 1 year. CONCLUSIONS: At the age of 1 year following cataract extraction in infants, contact lens correction and the lack of IOL placement are associated with a significant decrease in postoperative corneal astigmatism compared to IOL placement. No other surgical factors considered in this study had a statistically significant effect on corneal astigmatism.
RCT Entities:
PURPOSE: To evaluate the effect of surgical factors on postoperative astigmatism in infants undergoing cataract extraction with or without intraocular lens (IOL) implantation. METHODS: The Infant Aphakia Treatment Study is a multicenter clinical trial in which 114 infants with unilateral congenital cataracts were randomized to undergo cataract extraction with IOL placement or contact lens aphakic correction. Surgical videos were reviewed with regard to incision type and location, whether the incision was extended, the number of sutures placed, and technique of closure. Corneal astigmatism was measured using a handheld keratometer prior to surgery and at 1 year of age. RESULTS:Corneal astigmatism decreased from a mean of 1.92 D at baseline to 1.62 D at age 1 year in the contact lens group but remained almost unchanged from 2.00 D to 2.09 D in the IOL group (P = 0.023). There was no statistical difference between the amount of corneal astigmatism with regard to incision type (P = 0.214) and no increase in astigmatism with extension of the incision to facilitate IOL placement (P = 0.849) at 1 year. The number of sutures and technique of closure did not influence the amount of astigmatism at 1 year. CONCLUSIONS: At the age of 1 year following cataract extraction in infants, contact lens correction and the lack of IOL placement are associated with a significant decrease in postoperative corneal astigmatism compared to IOL placement. No other surgical factors considered in this study had a statistically significant effect on corneal astigmatism.
Authors: Yasmin S Bradfield; David A Plager; Daniel E Neely; Derek T Sprunger; Naval Sondhi Journal: J Cataract Refract Surg Date: 2004-09 Impact factor: 3.351
Authors: Scott R Lambert; Edward G Buckley; Carolyn Drews-Botsch; Lindreth DuBois; Eugenie Hartmann; Michael J Lynn; David A Plager; M Edward Wilson Journal: Arch Ophthalmol Date: 2010-01