title: A comparison of grating visual acuity, strabismus, and reoperation outcomes among children with aphakia and pseudophakia after unilateral cataract surgery during the first six months of life.
abstract: OBJECTIVE
  The method of correcting aphakia after unilateral cataract extraction during infancy is controversial. Some authorities advocate correction with an intraocular lens (IOL) whereas others advocate correction with a contact lens (CL). We compared grating visual acuity, alignment, and reoperative outcomes in age-matched children treated with these 2 modalities at 5 clinical centers.
  
  
  METHODS
  Twenty-five infants born in 1997 or 1998 with a dense unilateral congenital cataract who had cataract surgery coupled with (IOL group, n = 12) or without (CL group, n = 13) primary IOL implantation were enrolled in this study. All patients were prescribed half-time occlusion therapy. In July 1999, their grating visual acuities, ocular alignments, and reoperation rates were assessed.
  
  
  RESULTS
  The mean grating visual acuity (LogMAR) for the affected eye was 0.70 +/- 0.32 for the IOL group and 0.87 +/- 0.31 for the CL group (P =.19). The mean interocular difference in grating visual acuity was 0.26 +/- 0.30 for the IOL group and 0.50 +/- 0.28 for the CL group (P =.048). The incidence of strabismus (>10 PD) was 75% in the IOL group compared with 92% in the CL group (P =.24). The incidence of reoperations was 83% in the IOL group compared with 23% in the CL group (P =.003).
  
  
  CONCLUSIONS
  Our preliminary data suggest that correcting aphakia after unilateral congenital cataract surgery with primary IOL implantation results in an improved visual outcome but a higher rate of complications requiring reoperation. A randomized clinical trial, the Infant Aphakia Treatment Study, is planned to further study the optimal treatment for aphakia following unilateral cataract extraction during infancy.
authors: Emory Eye Center, Atlanta, Georgia 30322, USA.
authors: S R
authors: SR
authors: Lambert
authors: M
authors: M
authors: Lynn
authors: C
authors: C
authors: Drews-Botsch
authors: D
authors: D
authors: Loupe
authors: D A
authors: DA
authors: Plager
authors: N B
authors: NB
authors: Medow
authors: M E
authors: ME
authors: Wilson
authors: E G
authors: EG
authors: Buckley
authors: A V
authors: AV
authors: Drack
authors: S L
authors: SL
authors: Fawcett
mesh_terms: D001036:Aphakia, Postcataract / Q000503:physiopathology* / Q000628:therapy; D002386:Cataract / Q000151:congenital; D002387:Cataract Extraction; D003261:Contact Lenses; D006801:Humans; D015994:Incidence; D007223:Infant; D019654:Lens Implantation, Intraocular; D019591:Pseudophakia / Q000503:physiopathology* / Q000628:therapy; D012086:Reoperation; D012683:Sensory Deprivation; D013285:Strabismus / Q000209:etiology / Q000503:physiopathology*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology