title: Complications in the first 5 years following cataract surgery in infants with and without intraocular lens implantation in the Infant Aphakia Treatment Study.
abstract: OBJECTIVE
  To compare rates and severity of complications between infants undergoing cataract surgery with and without intraocular lens (IOL) implantation.
  
  
  METHODS
  Prospective randomized clinical trial.
  
  
  METHODS
  A total of 114 infants were enrolled in the Infant Aphakia Treatment Study, a randomized, multi-center (12) clinical trial comparing the treatment of unilateral aphakia in patients under 7 months of age with a primary IOL implant or contact lens. The rate, character, and severity of intraoperative complications, adverse events, and additional intraocular surgeries during the first 5 postoperative years in the 2 groups were examined.
  
  
  RESULTS
  There were more patients with intraoperative complications (28% vs 11%, P = .031), adverse events (81% vs 56%, P = .008), and more additional intraocular surgeries (72% vs 16%, P < .0001) in the IOL group than in the contact lens group. However, the number of patients with adverse events in the contact lens group increased (15 to 24) in postoperative years 2-5 compared to the first postoperative year, while it decreased (44 to 14) in years 2-5 compared to the first postoperative year in the IOL group. If only one half of the patients in the contact lens (aphakic) group eventually undergo secondary IOL implantation, the number of additional intraocular surgeries in the 2 groups will be approximately equal.
  
  
  CONCLUSIONS
  The increased rate of complications, adverse events, and additional intraocular surgeries associated with IOL implantation in infants <7 months of age militates toward leaving babies aphakic if it is considered likely that the family will be successful with contact lens correction.
authors: Indiana University Medical Center, Indianapolis, Indiana. Electronic address: dplager@iu.edu.
authors: David A
authors: DA
authors: Plager
authors: Emory University, Atlanta, Georgia.
authors: Michael J
authors: MJ
authors: Lynn
authors: Duke University, Durham, North Carolina.
authors: Edward G
authors: EG
authors: Buckley
authors: Medical University of South Carolina, Charleston, South Carolina.
authors: M Edward
authors: ME
authors: Wilson
authors: Emory University, Atlanta, Georgia.
authors: Scott R
authors: SR
authors: Lambert
mesh_terms: D001036:Aphakia, Postcataract / Q000628:therapy*; D002386:Cataract / Q000151:congenital*; D002387:Cataract Extraction / Q000009:adverse effects*; D003261:Contact Lenses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007910:Lenses, Intraocular; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity