NOV 20, 2014
Pediatric Ophth/Strabismus
This analysis of data from the Infant Aphakia Treatment Study found that infants who underwent primary IOL implantation before the age of 7 months experienced more postoperative adverse events and required more additional intraocular surgeries over a five-year period.
This prospective, randomized clinical trial included 114 patients under 7 months of age with unilateral congenital cataract being treated for unilateral aphakia with a primary IOL or contact lens.
Patients who underwent IOL implantation experienced more intraoperative complications (28% vs. 11%, P = 0.031), adverse events (81% vs. 56%, P = 0.008) and additional intraocular surgeries (72% vs. 16%, P < 0.0001) than those treated with contact lenses over the first five years after surgery.
However, during postoperative years two through five compared to the first postoperative year, the number of patients with adverse events increased from 15 to 24 in the contact lens group and decreased from 44 to 14 in the IOL group.
The authors note that while primary IOL implantation in early infancy was associated with no visual benefit at 5 years of age, an increased risk of adverse events and additional intraocular surgeries, there are other factors that could influence the decision whether to implant an IOL in a particular baby. They say that the data favor delaying IOL implantation until the child is older for families that can reasonably manage contact lens care and expense.