The Infant Aphakia Treatment Study: Evaluation of cataract morphology in eyes with monocular cataracts

• Type of Material: Article
• Authors: M. Edward Wilson, Medical University of South Carolina; Rupal H. Trivedi, Medical University of South Carolina; David G. Morrison, Vanderbilt University; Scott Lambert, Emory University; Edaward G. Buckley, Duke University; David A. Plager, Indiana University; Michael Lynn, Emory University
• Language: English
• Date: 2011-10-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Copyright © 2011 by the American Association for Pediatric Ophthalmology and Strabismus.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jaapos.2011.05.016
• Title of Journal or Parent Work: Journal of AAPOS
• ISSN: 1091-8531
• Volume: 15
• Issue: 5
• Start Page: 421
• End Page: 426
• Grant/Funding Information: This study was supported by grants U10 EY13272 and U10 EY013287 from the National Institutes of Health; and in part by an unrestricted grant to MUSC-SEI from Research to Prevent Blindness, Inc, New York, NY; and the Grady Lyman Fund.
• Keywords: PLAQUE; Life Sciences & Biomedicine; Ophthalmology; Pediatrics; CHILDREN; Science & Technology
• Research Categories: Health Sciences, Opthamology

Abstract

Purpose: To describe a video-documented assessment of cataract type in the eyes of patients with monocular infantile cataract who were enrolled in the Infant Aphakia Treatment Study. Methods: The Infant Aphakia Treatment Study is a randomized clinical trial in which the investigators compared intraocular lens (IOL) versus contact lens correction in 114 infants, aged 28 days to <7 months. A total of 83 videos were available for morphological analysis of cataract. Three examiners reviewed all surgical recordings and agreed on the cataract characteristics by using a score sheet to record the lens layer or configuration of the opacity. Results: Nuclear cataract was present in 45 of 83 eyes (54%). Posterior capsule plaque was observed in 73 eyes (88%). All eyes with fetal nuclear cataract had associated posterior capsule plaque. Cortical cataract without nuclear involvement was seen in 21 eyes (25%). Posterior bowing of the posterior capsule was noted in 4 eyes (5%). Evidence of persistent fetal vasculature (PFV) was present in 18 eyes (22%). PFV was the only finding in 5 eyes but was also seen in combination with nuclear (7 eyes) and cortical cataracts (6 eyes). The entire lens was white in 3 eyes (4%), whereas the lens was partially resorbed in 7 (8%) eyes. Anterior capsule fibrosis was noted in 5 eyes with advanced cataract (1 with total cataract, 4 with partially resorbed lens). Conclusions: Nuclear opacities were common, but many different cataract types presented in infancy. PFV occurred in isolation or in association with cataract. Posterior capsule plaque was frequently noted, especially when a nuclear cataract was present.