Spectacle Adherence Among Four-Year-Old Children in the Infant Aphakia Treatment Study

• Type of Material: Article
• Authors: Scott Lambert, Emory University; Lindreth Dubois, Emory University; George Cotsonis, Emory University; E. Eugenie Hartmann, Emory University; Carolyn Drews-Botsch, Emory University
• Language: English
• Date: 2019-04-01
• Publisher: Elsevier Science Inc.
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ajo.2018.12.017
• Title of Journal or Parent Work: American Journal of Ophthalmology
• Volume: 200
• Start Page: 26
• End Page: 33
• Grant/Funding Information: Supported by National Institutes of Health Grants U10 EY13272, U10 EY013287, UG1 EY013272, 1UG1 EY025553, P30 EY026877 and Research to Prevent Blindness, Inc, New York, New York.
• Keywords: Ophthalmology; Science & Technology; Impairment; Visual acuity; Contact lens; Eye injuries; Stereopsis; Amblyopia treatment; Occlusion therapy; Association; Life Sciences & Biomedicine; Intraocular-lens implantation; Wear
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Opthamology; Health Sciences, Rehabilitation and Therapy

Abstract

Purpose: To evaluate spectacle adherence with impact-resistant lenses among 4-year-old children after unilateral cataract surgery in the Infant Aphakia Treatment Study. Design: Retrospective cohort analysis of randomized clinical trial data. Methods: SETTING: Multicenter. PATIENTS: One hundred and fourteen children randomized to contact lens correction or intraocular lens implantation following unilateral cataract surgery during infancy. INTERVENTION: One-week diaries completed annually and retrospective telephone interviews conducted every 3 months to age 5 years to assess spectacle adherence with impact-resistant lenses. Visual acuity was assessed by a traveling examiner at age 4.5 years. MAIN OUTCOME MEASURES: Spectacle adherence between ages 4 and 5 years. Results: Children with 20/40 or better vision in their treated eye were more likely to wear spectacles ≥80% of their waking hours than children with vision worse than 20/40 (66% vs 42%, P =.034). Reported adherence to spectacle wear correlated with reported patching (r = 0.30, P =.002). Spectacle adherence did not correlate with sex, type of healthcare insurance, or the refractive error in the treated or fellow eye. Seven patients with reduced vision in their treated eye reported <10% spectacle adherence. Conclusions: These results confirm that it is possible to achieve high levels of spectacle adherence among 4-year-old children after unilateral cataract surgery during infancy. However, children with vision worse than 20/40 in their worse eye, who needed eye protection the most, had the worst adherence.