Strabismus surgery outcomes in the Infant Aphakia Treatment Study (TATS) at age 5 years

• Type of Material: Article
• Authors: Erick D. Bothun, University of Minnesota; Michael J. Lynn, Emory University; Stephen P. Christiansen, Boston University; Stacey J. Kruger, Miami, Florida; Deborah K. Vanderveen, Harvard University; Dan E. Neely, Indiana University; Scott Lambert, Emory University
• Language: English
• Date: 2016-12-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016, American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jaapos.2016.09.014
• Title of Journal or Parent Work: Journal of AAPOS
• ISSN: 1091-8531
• Volume: 20
• Issue: 6
• Start Page: 501
• End Page: 505
• 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: CONGENITAL CATARACTS; INTRAOCULAR-LENS IMPLANTATION; COMPLICATIONS; LIFE; STEREOPSIS; CHILDREN; Ophthalmology; Pediatrics; CATARACT-SURGERY; Science & Technology; PSEUDOPHAKIA; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Epidemiology; Biology, Biostatistics; Health Sciences, Medicine and Surgery

Abstract

PURPOSE: To report strabismus surgery frequency and outcomes after monocular infantile cataract surgery with or without IOL implantation. METHODS: The Infant Aphakia Treatment Study (IATS) is a randomized, multicenter clinical trial comparing treatment of aphakia with a primary IOL or contact lens in 114 infants with a unilateral congenital cataract. This report is a secondary outcome analysis of ocular motor data from IATS patients who underwent strabismus surgery prior to age 5 years. RESULTS: Strabismus surgery was performed in 45 (39%) patients (contact lens group [CL], 37%; IOL group, 42% [P = 0.70]). The indications for strabismus surgery were esotropia (62%), exotropia (33%), and hypertropia (4%). Infants who underwent cataract surgery at a younger age were less likely to undergo strabismus surgery (28-48 days, 12/50 [24%]; 49-210 days, 33/64 [52%]; P = 0.0037). Of the 42 patients who underwent strabismus surgery, 14 (33%) had a postoperative distance alignment within 8Δ of orthotropia at age 5 years. The 5-year visual acuity of children with strabismus was the same whether or not strabismus surgery had been performed (1.10 logMAR with surgery vs 1.00 without [P = 0.71]). CONCLUSIONS: In this study cohort, cataract surgery performed in the first 6 weeks of life was associated with a reduced frequency of strabismus surgery. Strabismus surgery outcomes in this population are guarded. Surgical improvement of strabismus does not appear to influence long-term visual acuity.