Outcomes of Unilateral Cataracts in Infants and Toddlers 7 to 24 Months of Age: Toddler Aphakia and Pseudophakia Study (TAPS).

Abstract

PURPOSE:

To evaluate outcomes of unilateral cataract surgery in children 7 to 24 months of age.

DESIGN:

Retrospective case series at 10 Infant Aphakia Treatment Study (IATS) sites.

PARTICIPANTS:

The Toddler Aphakia and Pseudophakia Study is a registry of children treated by surgeons who participated in the IATS.

METHODS:

Children underwent unilateral cataract surgery with or without intraocular lens (IOL) placement during the IATS enrollment years of 2004 and 2010.

MAIN OUTCOME MEASURES:

Intraoperative complications, adverse events (AEs), visual acuity, and strabismus.

RESULTS:

Fifty-six children were included with a mean postoperative follow-up of 47.6 months. Median age at cataract surgery was 13.9 months (range, 7.2-22.9). Ninety-two percent received a primary IOL. Intraoperative complications occurred in 4 patients (7%). At 5 years of age, visual acuity of treated eyes was very good (≥20/40) in 11% and poor (≤20/200) in 44%. Adverse events were identified in 24%, with a 4% incidence of glaucoma suspect. An additional unplanned intraocular surgery occurred in 14% of children. Neither AEs nor intraocular reoperations were more common for children with surgery at 7 to 12 months of age than for those who underwent surgery at 13 to 24 months of age (AE rate, 21% vs. 25% [P = 0.60]; reoperation rate, 13% vs. 16% [P = 1.00]).

CONCLUSIONS:

Although most children underwent IOL implantation concurrent with unilateral cataract removal, the incidence of complications, reoperations, and glaucoma was low when surgery was performed between 7 and 24 months of age and compared favorably with same-site IATS data for infants undergoing surgery before 7 months of age. Our study showed that IOL implantation is relatively safe in children older than 6 months and younger than 2 years.

• Authors: Erick D Bothun, M Edward Wilson, Elias I Traboulsi, Nancy N Diehl, David A Plager, Deborah K Vanderveen, Sharon F Freedman, Kimberly G Yen, Natalie C Weil, Allison R Loh, David Morrison, Jill S Anderson, Scott R Lambert, Toddler Aphakia and Pseudophakia Study Group (TAPS)
• Journal: Ophthalmology (Ophthalmology) Vol. 126 Issue 8 Pg. 1189-1195 (08 2019) ISSN: 1549-4713 [Electronic] United States
• PMID: 30880109 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Topics

• Aphakia, Postcataract (surgery)
• Cataract (complications)
• Cataract Extraction (adverse effects)
• Female
• Humans
• Incidence
• Infant
• Intraoperative Complications (epidemiology)
• Lens Implantation, Intraocular (adverse effects)
• Male
• Postoperative Complications (epidemiology)
• Pseudophakia (complications)
• Retrospective Studies
• Visual Acuity