Visual outcome and success of amblyopia treatment in unilateral small posterior lens opacities and lenticonus initially treated nonsurgically.
OBJECTIVE
We sought to assess the success of amblyopia treatment in patients with small posterior lens opacities as well as the factors associated with a good visual outcome.


METHODS
This was a retrospective study of patients with posterior lens opacities that initially were thought to be too small in size to warrant cataract surgery. The following variables were examined: cataract type, location, diameter, persistent hyaloid vessel, anisometropia, strabismus, and age of detection. Success of treatment of amblyopia was defined as improvement by at least 0.3 logMAR units. Good visual outcome was defined as 20/40 or better. Amblyopia was treated by glasses, patching, and/or atropine. Patients who failed with conservative treatment or had an increase in cataract size underwent surgery.


RESULTS
Forty-eight (91%) of 53 eyes were amblyopic. Thirty amblyopic eyes had pre- and post-treatment Snellen acuities. Twenty (67%) had their visual acuity (VA) improved by 0.3 logMAR units or greater. None of the measured variables were associated with successful amblyopia treatment. Twenty-five (49%) of 51 patients had a final VA of 20/40 or better. The only variable associated with good visual outcome was cataract type: 18 of 25 (72%) posterior subcapsular cataract and 6 of 23 (32%) posterior lenticonus eyes achieved VA of 20/40 or better (P = 0.008). Six patients who went on to have cataract surgery experienced a larger improvement in BCVA (4.50 logMar units +/- 2.52 lines) compared with patients treated without cataract surgery (2.36 logMar units +/- 3.11 lines).


CONCLUSIONS
Amblyopia treatment was successful in most cases. A small group of patients who underwent cataract surgery experienced a greater VA improvement; however, it was not statistically significant. Further studies are needed to determine which patients would benefit from cataract surgery.
Travi
Giovanni M
GM
Wills Eye Hospital, Philadelphia, PA, USA. gmtravi@uol.com.br
Schnall
Bruce M
BM
Lehman
Sharon S
SS
Kelly
Christopher J
CJ
Hug
Denise
D
Hirakata
Vânia N
VN
Calhoun
Joseph H
JH
D000550:Amblyopia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D001285:Atropine / Q000008:administration & dosage / Q000627:therapeutic use; D002386:Cataract / Q000150:complications* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007905:Lens Diseases / Q000150:complications* / Q000628:therapy; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D012189:Retrospective Studies; D012683:Sensory Deprivation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*
D009184:Mydriatics; D009883:Ophthalmic Solutions; D001285:Atropine