Erick D Bothun1, Michael J Lynn2, Stephen P Christiansen3, Dan E Neely4, Deborah K Vanderveen5, Stacey J Kruger6, Scott R Lambert7. 1. Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Electronic address: Bothu003@umn.edu. 2. Department of Biostatistics and Bioinformations, Rollins School of Public Health, Emory University, Atlanta, Georgia. 3. Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts; Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts. 4. Department of Ophthalmology, Indiana University, Indianapolis, Indiana. 5. Department of Ophthalmology, Harvard University, Boston, Massachusetts. 6. Private Practice, Miami, Florida. 7. Department of Ophthalmology, Emory University, Atlanta, Georgia.
Abstract
PURPOSE: To evaluate sensorimotor outcomes among children in the Infant Aphakia Treatment Study (IATS). METHODS: Secondary outcome analysis was performed in this randomized, multicenter, clinical trial comparing treatment of unilateral aphakia with a primary intraocular lens (IOL) or contact lens (CL) correction. The alignment characteristics and sensory status of children through age 5 years were evaluated. RESULTS: In the IATS study, 91 of 112 children (81%) developed strabismus through age 5 years. Of 34 infants who were orthotropic at near 12 months after cataract surgery, at age 5 years 14 (41%) were orthotropic at distance, and 15 (44%) were orthotropic at near at age 5 years without strabismus surgery. Eight of 56 children (14%) in the CL group and 13 of 56 (23%) in the IOL group were orthotropic at distance (P = 0.33) at 5 years of age and had no history of strabismus surgery. Thirteen of 48 (27%) who underwent cataract surgery prior to 49 days of age compared to 8 of 64 (13%) who had surgery after 49 days were orthotropic (P = 0.085). Median visual acuity in the operative eye was 0.4 logMAR (20/50) for children with orthotropia or microtropia (<10(Δ)) versus 1.10 logMAR (20/252) for strabismus ≥10(Δ) (P = 0.0001). Stereopsis was detected in 12 of 21 children (57%) with orthotropia versus 16 of 89 (18%) children with strabismus (P = 0.0006). CONCLUSIONS:IOL placement does not reduce the development of strabismus after monocular congenital cataract surgery. Improved ocular alignment by age 5 years correlated strongly with improved visual acuity and stereopsis.
RCT Entities:
PURPOSE: To evaluate sensorimotor outcomes among children in the InfantAphakia Treatment Study (IATS). METHODS: Secondary outcome analysis was performed in this randomized, multicenter, clinical trial comparing treatment of unilateral aphakia with a primary intraocular lens (IOL) or contact lens (CL) correction. The alignment characteristics and sensory status of children through age 5 years were evaluated. RESULTS: In the IATS study, 91 of 112 children (81%) developed strabismus through age 5 years. Of 34 infants who were orthotropic at near 12 months after cataract surgery, at age 5 years 14 (41%) were orthotropic at distance, and 15 (44%) were orthotropic at near at age 5 years without strabismus surgery. Eight of 56 children (14%) in the CL group and 13 of 56 (23%) in the IOL group were orthotropic at distance (P = 0.33) at 5 years of age and had no history of strabismus surgery. Thirteen of 48 (27%) who underwent cataract surgery prior to 49 days of age compared to 8 of 64 (13%) who had surgery after 49 days were orthotropic (P = 0.085). Median visual acuity in the operative eye was 0.4 logMAR (20/50) for children with orthotropia or microtropia (<10(Δ)) versus 1.10 logMAR (20/252) for strabismus ≥10(Δ) (P = 0.0001). Stereopsis was detected in 12 of 21 children (57%) with orthotropia versus 16 of 89 (18%) children with strabismus (P = 0.0006). CONCLUSIONS: IOL placement does not reduce the development of strabismus after monocular congenital cataract surgery. Improved ocular alignment by age 5 years correlated strongly with improved visual acuity and stereopsis.
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: Erick D Bothun; Julia Cleveland; Michael J Lynn; Stephen P Christiansen; Deborah K Vanderveen; Dan E Neely; Stacey J Kruger; Scott R Lambert Journal: Ophthalmology Date: 2013-02-16 Impact factor: 12.079
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
Authors: Erick D Bothun; Michael J Lynn; Stephen P Christiansen; Stacey J Kruger; Deborah K Vanderveen; Dan E Neely; Scott R Lambert Journal: J AAPOS Date: 2016-11-02 Impact factor: 1.220
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