The Infant Aphakia Treatment Study: Further on intra- and postoperative complications in the intraocular lens group

• Type of Material: Article
• Authors: Scott Lambert, Emory University; David A. Plager, Indiana University; Edward G. Buckley, Medical University of South Carolina; M. Edward Wilson, Duke University; Lindreth Dubois, Emory University; Carolyn D. Drews-Botsch, Emory University; Eugenie E. Hartmann, University of Alabama at Birmingham; Michael Lynn, Emory University
• Language: English
• Date: 2015-04-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jaapos.2015.01.012
• Title of Journal or Parent Work: Journal of AAPOS
• ISSN: 1091-8531
• Volume: 19
• Issue: 2
• Start Page: 101
• End Page: 103
• Grant/Funding Information: Supported by National Institutes of Health Grants U10 EY13272 and U10 EY013287 and in part by NIH Departmental Core Grant EY06360 and Research to Prevent Blindness, Inc, New York, New York.
• Keywords: Ophthalmology; Life Sciences & Biomedicine; RANDOMIZED CLINICAL-TRIAL; Pediatrics; AGE; ADVERSE EVENTS; CONTACT-LENS; GLAUCOMA; CATARACT-SURGERY; MONOCULAR APHAKIA
• Research Categories: Health Sciences, Opthamology; Health Sciences, Medicine and Surgery

Abstract

The Infant Aphakia Treatment Study (IATS) did not find a significant difference in visual acuity for infants with a unilateral congenital cataract <7 months of age who were corrected with a contact lens compared to an intraocular lens (IOL) after cataract surgery. However, there were significantly more intraoperative and postoperative adverse events and additional intraocular surgeries in the IOL group compared to the contact lens group. This outcome prompted the recommendation that IOL implantation be limited to infants at risk of experiencing “significant periods of uncorrected aphakia” if an IOL was not implanted. Some pediatric cataract surgeons have speculated that if the IATS protocol had been designed differently or if more experienced surgeons had performed the cataract surgeries that the high rate of adverse events in the IOL group would have been averted. Some of these critiques have been published as letters-to-the editor and others have been raised in forums, both public and private.3 In this report, we address these issues and, in some areas, we provide additional outcome data from the IATS to help clarify areas where there may have been misunderstandings.