Refractive growth variability in the Infant Aphakia Treatment Study

• Type of Material: Article
• Authors: Scott K McClatchey, Naval Medical Center, San Diego; Thaddeus S McClatchey, Naval Medical Center, San Diego; George Cotsonis, Emory University; Azhar Nizam, Emory University; Scott Lambert, Emory University
• Language: English
• Date: 2021-04-01
• Publisher: Wolters Kluwer
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/j.jcrs.0000000000000482
• Title of Journal or Parent Work: Journal of cataract and refractive surgery
• Volume: 47
• Issue: 4
• Start Page: 512
• End Page: 515
• Grant/Funding Information: Supported by National Institutes of Health Grants U10 EY13272, U10 EY013287, UG1 EY013272, UG1 EY025553, P30 EY026877 and Research to Prevent Blindness, Inc, and the Norm Medow Foundation
• Keywords: Cataract; Aphakia; Cornea; Infant; Humans; Retrospective Studies; Aphakia, Postcataract; Cataract Extraction; Lens Implantation, Intraocular; Follow-Up Studies

Abstract

PURPOSE: Prediction of refraction after cataract surgery in children is limited by the variance in rate of refractive growth (RRG3). This study compared RRG3 in aphakic and pseudophakic eyes with their fellow, normal eyes in the Infant Aphakia Treatment Study. SETTING: Twelve clinical sites in the United States. DESIGN: Randomized clinical trial. METHODS: Infants randomized to unilateral cataract extraction had RRG3 calculated based on biometric data (axial length and keratometry) at cataract surgery and at 10 years of age, for both the normal and cataract eyes. Subjects were included if complete biometric data from both eyes were available both at surgery and at 10 years. Variance in RRG3 was compared between the groups with Pitman test for equality of variance between correlated samples. RESULTS: Longitudinal biometric data were available for 103 of the 114 patients enrolled. RRG3 was -15.00 diopters (D) (3.00 D) for normal eyes (reported as mean [SD]), -17.70 D (6.20 D) for aphakic eyes, and -16.70 D (6.20 D) for pseudophakic eyes (P < .0001 for comparison of variances in RRG3 between normal and all operated eyes). Further analysis found differences in the variance in axial length growth (P < .0001) between operated and normal eyes; the variance in keratometry measurement change did not reach significance. CONCLUSIONS: The standard deviation in the RRG3 of normal eyes in our study was half of that found in eyes that underwent cataract surgery.