Abstract | PURPOSE: To evaluate outcomes of bilateral cataract surgery in children aged 7 to 24 months and compare rates of adverse events (AEs) with other Toddler Aphakia and Pseudophakia Study (TAPS) registry outcomes. DESIGN: Retrospective clinical study at 10 Infant Aphakia Treatment Study (IATS) sites. Statistical analyses comparing this cohort with previously reported TAPS registry cohorts. PARTICIPANTS: Children enrolled in the TAPS registry between 2004 and 2010. METHODS: Children underwent bilateral cataract surgery with or without intraocular lens (IOL) placement at age 7 to 24 months with 5 years of postsurgical follow-up. MAIN OUTCOME MEASURES: Visual acuity (VA), occurrence of strabismus, AEs, and reoperations. RESULTS: A total of 40 children (76 eyes) who underwent bilateral cataract surgery with primary posterior capsulectomy were identified with a median age at cataract surgery of 11 months (7-23); 68% received a primary IOL. Recurrent visual axis opacification (VAO) occurred in 7.5% and was associated only with the use of an IOL (odds ratio, 6.10; P = 0.005). Glaucoma suspect (GS) was diagnosed in 2.5%, but no child developed glaucoma. In this bilateral cohort, AEs (8/40, 20%), including glaucoma or GS and VAO, and reoperations occurred in a similar proportion to that of the published unilateral TAPS cohort. When analyzed with children aged 1 to 7 months at bilateral surgery, the incidence of AEs and glaucoma or GS correlated strongly with age at surgery (P = 0.011/0.004) and glaucoma correlated with microcornea (P = 0.040) but not with IOL insertion (P = 0.15). CONCLUSIONS: Follow-up to age 5 years after bilateral cataract surgery in children aged 7 to 24 months reveals a low rate of VAO and very rare glaucoma or GS diagnosis compared with infants with cataracts operated at < 7 months of age despite primary IOL implantation in most children in the group aged 7 to 24 months. The use of an IOL increases the risk of VAO irrespective of age at surgery.
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Authors | Erick D Bothun, M Edward Wilson, Kimberly G Yen, Jill S Anderson, Natalie C Weil, Allison R Loh, David Morrison, Sharon F Freedman, David A Plager, Deborah K Vanderveen, Elias I Traboulsi, David O Hodge, Scott R Lambert, Toddler Aphakia and Pseudophakia Study |
Journal | Ophthalmology
(Ophthalmology)
Vol. 128
Issue 2
Pg. 302-308
(02 2021)
ISSN: 1549-4713 [Electronic] United States |
PMID | 32679160
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. |
Topics |
- Aphakia, Postcataract
(epidemiology)
- Cataract
(congenital)
- Cataract Extraction
- Child, Preschool
- Female
- Follow-Up Studies
- Glaucoma
(diagnosis, etiology)
- Humans
- Infant
- Lens Implantation, Intraocular
- Lenses, Intraocular
(adverse effects)
- Male
- Pseudophakia
(epidemiology)
- Registries
(statistics & numerical data)
- Retrospective Studies
- Treatment Outcome
- Vision Disorders
(diagnosis, etiology)
- Visual Acuity
(physiology)
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