Strabismus surgery outcomes in the Infant Aphakia Treatment Study (IATS) at age 5 years.
To report strabismus surgery frequency and outcomes after monocular infantile cataract surgery with or without IOL implantation.



The Infant Aphakia Treatment Study (IATS) is a randomized, multicenter clinical trial comparing treatment of aphakia with a primary IOL or contact lens in 114 infants with a unilateral congenital cataract. This report is a secondary outcome analysis of ocular motor data from IATS patients who underwent strabismus surgery prior to age 5 years.



Strabismus surgery was performed in 45 (39%) patients (contact lens group [CL], 37%; IOL group, 42% [P = 0.70]). The indications for strabismus surgery were esotropia (62%), exotropia (33%), and hypertropia (4%). Infants who underwent cataract surgery at a younger age were less likely to undergo strabismus surgery (28-48 days, 12/50 [24%]; 49-210 days, 33/64 [52%]; P = 0.0037). Of the 42 patients who underwent strabismus surgery, 14 (33%) had a postoperative distance alignment within 8Δof orthotropia at age 5 years. The 5-year visual acuity of children with strabismus was the same whether or not strabismus surgery had been performed (1.10 logMAR with surgery vs 1.00 without [P = 0.71]).



In this study cohort, cataract surgery performed in the first 6 weeks of life was associated with a reduced frequency of strabismus surgery. Strabismus surgery outcomes in this population are guarded. Surgical improvement of strabismus does not appear to influence long-term visual acuity.
Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota. Electronic address: bothun.erick@mayo.edu.
Erick D
ED
Bothun
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Michael J
MJ
Lynn
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.
Stephen P
SP
Christiansen
Miami, Florida.
Stacey J
SJ
Kruger
Harvard University, Boston, Massachusetts.
Deborah K
DK
Vanderveen
Department of Ophthalmology, Indiana University, Indianapolis.
Dan E
DE
Neely
Department of Ophthalmology, Emory University, Atlanta, Georgia; Department of Ophthalmology, Standford University School of Medicine, Stanford, California.
Scott R
SR
Lambert
D001036:Aphakia, Postcataract; D002386:Cataract / Q000150:complications*; D002387:Cataract Extraction; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019654:Lens Implantation, Intraocular; D008297:Male; D019591:Pseudophakia; D013285:Strabismus / Q000150:complications / Q000601:surgery*