title: Sensorimotor outcomes by age 5 years after monocular cataract surgery in the Infant Aphakia Treatment Study (IATS).
abstract: OBJECTIVE
  To evaluate sensorimotor outcomes among children in the Infant Aphakia Treatment Study (IATS).
  
  
  METHODS
  Secondary outcome analysis was performed in this randomized, multicenter, clinical trial comparing treatment of unilateral aphakia with a primary intraocular lens (IOL) or contact lens (CL) correction. The alignment characteristics and sensory status of children through age 5 years were evaluated.
  
  
  RESULTS
  In the IATS study, 91 of 112 children (81%) developed strabismus through age 5 years. Of 34 infants who were orthotropic at near 12 months after cataract surgery, at age 5 years 14 (41%) were orthotropic at distance, and 15 (44%) were orthotropic at near at age 5 years without strabismus surgery. Eight of 56 children (14%) in the CL group and 13 of 56 (23%) in the IOL group were orthotropic at distance (P = 0.33) at 5 years of age and had no history of strabismus surgery. Thirteen of 48 (27%) who underwent cataract surgery prior to 49 days of age compared to 8 of 64 (13%) who had surgery after 49 days were orthotropic (P = 0.085). Median visual acuity in the operative eye was 0.4 logMAR (20/50) for children with orthotropia or microtropia (<10(Δ)) versus 1.10 logMAR (20/252) for strabismus ≥10(Δ) (P = 0.0001). Stereopsis was detected in 12 of 21 children (57%) with orthotropia versus 16 of 89 (18%) children with strabismus (P = 0.0006).
  
  
  CONCLUSIONS
  IOL placement does not reduce the development of strabismus after monocular congenital cataract surgery. Improved ocular alignment by age 5 years correlated strongly with improved visual acuity and stereopsis.
authors.affiliation: Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Electronic address: Bothu003@umn.edu.
authors.forename: Erick D
authors.initials: ED
authors.lastname: Bothun
authors.affiliation: Department of Biostatistics and Bioinformations, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lynn
authors.affiliation: Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts; Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Christiansen
authors.affiliation: Department of Ophthalmology, Indiana University, Indianapolis, Indiana.
authors.forename: Dan E
authors.initials: DE
authors.lastname: Neely
authors.affiliation: Department of Ophthalmology, Harvard University, Boston, Massachusetts.
authors.forename: Deborah K
authors.initials: DK
authors.lastname: Vanderveen
authors.affiliation: Private Practice, Miami, Florida.
authors.forename: Stacey J
authors.initials: SJ
authors.lastname: Kruger
authors.affiliation: Department of Ophthalmology, Emory University, Atlanta, Georgia.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Lambert
mesh_terms: D001036:Aphakia, Postcataract / Q000503:physiopathology / Q000628:therapy*; D002386:Cataract / Q000151:congenital*; D002387:Cataract Extraction; D002675:Child, Preschool; D003261:Contact Lenses; D003867:Depth Perception / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019654:Lens Implantation, Intraocular; D008297:Male; D019591:Pseudophakia / Q000503:physiopathology; D066191:Sensorimotor Cortex / Q000503:physiopathology*; D013285:Strabismus / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D014792:Visual Acuity / Q000502:physiology