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Migration to aphakia and contact lens treatment is the trend in the management of unilateral congenital cataract in Britain and Ireland

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Abstract

Background

The Infant Aphakia Treatment Study (IATS) compared the treatment of unilateral cataract in infants aged 1–6 months with primary intraocular lens (IOL) implantation vs aphakia with contact lens (CL) correction.

Aims

This study aims to assess the current trends in the treatment of unilateral congenital cataract in infants less than 6 months at surgery in the UK and Ireland.

Methods

An anonymous survey was emailed to the 200 members of the BIPOSA mailing list with 14 questions to assess treatment choice (primary intraocular lens (IOL) vs aphakia with contact lens (CL)), reasons for this choice, and assessment of local CL services.

Results

There were 56 respondents, 39 of whom completed the entire survey. Aphakia with CL was the treatment choice for 74.4% of respondents. A quarter (25.6%) of respondents said they were performing primary IOL implantation prior to the publication of the Infant Aphakia Treatment Study (IATS), but now choose aphakia with CL. Amongst the 20.5% (n = 8) of respondents who chose primary IOL implantation, 5 attributed their choice to “inadequate CL service”. The majority (84.6%) of respondents rated their infant CL service as either “good” or “very good”.

Conclusion

Aphakia with CL rehabilitation was the most common approach to the treatment of unilateral congenital cataract in infants less than 6 months in this study. The results of the IATS appear to have influenced a change in practice from primary IOL implantation to aphakia and CL visual rehabilitation in approximately one quarter of those surveyed.

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References

  1. Ryan SJ, Maumenee AE (1977) Unilateral congenital cataracts and their management. Ophthalmic Surg 8(5):35–39

    CAS  PubMed  Google Scholar 

  2. Wilson ME Jr, Trivedi RH, Buckley EG, Granet DB, Lambert SR, Plager DA et al (2007) ASCRS white paper. Hydrophobic acrylic intraocular lenses in children. J Cataract Refract Surg 33(11):1966–1973

    Article  PubMed  Google Scholar 

  3. Wilson ME (1996) Intraocular lens implantation: has it become the standard of care for children? Ophthalmology 103(11):1719–1720

    Article  CAS  PubMed  Google Scholar 

  4. Lambert SR, Buckley EG, Plager DA, Medow NB, Wilson ME (1999) Unilateral intraocular lens implantation during the first six months of life. J AAPOS 3(6):344–349

    Article  CAS  PubMed  Google Scholar 

  5. Lambert SR, Lynn M, Drews-Botsch C, Loupe D, Plager DA, Medow NB, Wilson ME, Buckley EG, Drack AV, Fawcett SL (2001) 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. J AAPOS 5(2):70–75

    Article  CAS  PubMed  Google Scholar 

  6. Lambert SR, Lynn MJ, Hartmann EE, DuBois L, Drews-Botsch C, Freedman SF et al (2014) Comparison of contact lens and intraocular lens correction of monocular aphakia during infancy: a randomized clinical trial of HOTV optotype acuity at age 4.5 years and clinical findings at age 5 years. JAMA Ophthalmol 132(6):676–682

    Article  PubMed  Google Scholar 

  7. Bothun ED, Lynn MJ, Christiansen SP, Neely DE, Vanderveen DK, Kruger SJ, Lambert SR (2016) Sensorimotor outcomes by age 5 years after monocular cataract surgery in the Infant Aphakia Treatment Study (IATS). J AAPOS 20(1):49–53

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hartmann EE, Stout AU, Lynn MJ, Yen KG, Kruger SJ, Lambert SR (2015) Stereopsis results at 4.5 years of age in the infant aphakia treatment study. Am J Ophthalmol 159(1):64–70.e1–2

    Article  PubMed  Google Scholar 

  9. Freedman SF, Lynn MJ, Beck AD, Bothun ED, Orge FH, Lambert SR (2015) Glaucoma-related adverse events in the first 5 years after unilateral cataract removal in the Infant Aphakia Treatment Study. JAMA Ophthalmol 133(8):907–914

    Article  PubMed  PubMed Central  Google Scholar 

  10. Plager DA, Lynn MJ, Buckley EG, Wilson ME, Lambert SR (2014) Complications in the first 5 years following cataract surgery in infants with and without intraocular lens implantation in the Infant Aphakia Treatment Study. Am J Ophthalmol 158(5):892–898

    Article  PubMed  PubMed Central  Google Scholar 

  11. [Available from: www.surveymonkey.com

  12. Solebo AL, Russell-Eggitt I, Cumberland PM, Rahi JS (2015) Risks and outcomes associated with primary intraocular lens implantation in children under 2 years of age: the IoLunder2 cohort study. Br J Ophthalmol 99(11):1471–1476

    Article  PubMed  Google Scholar 

  13. Russell B, DuBois L, Lynn M, Ward MA, Lambert SR (2017) The Infant Aphakia Treatment Study contact lens experience to age 5 years. Eye Contact Lens 43(6):352–357

    Article  PubMed  PubMed Central  Google Scholar 

  14. Trivedi RH, Wilson ME, Vasavada AR, Shah SK, Vasavada V, Vasavada VA (2011) Visual axis opacification after cataract surgery and hydrophobic acrylic intraocular lens implantation in the first year of life. J Cataract Refract Surg 37(1):83–87

    Article  PubMed  Google Scholar 

  15. Bowman RJ, Kabiru J, Negretti G, Wood ML (2007) Outcomes of bilateral cataract surgery in Tanzanian children. Ophthalmology 114(12):2287–2292

    Article  PubMed  Google Scholar 

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Correspondence to Lisa McAnena.

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McAnena, L., McCreery, K. & Brosnahan, D. Migration to aphakia and contact lens treatment is the trend in the management of unilateral congenital cataract in Britain and Ireland. Ir J Med Sci 188, 1021–1024 (2019). https://doi.org/10.1007/s11845-018-1908-9

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  • DOI: https://doi.org/10.1007/s11845-018-1908-9

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