Sensorimotor outcomes by age 5 years after monocular cataract surgery in the Infant Aphakia Treatment Study (IATS)
Sensorimotor outcomes by age 5 years after monocular cataract surgery in the Infant Aphakia Treatment Study (IATS)
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DOI：
10.1016/j.jaapos.2015.11.002
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发表时间：
2016-02-01
期刊：
影响因子：
1.6
通讯作者：
Lambert, Scott R.
中科院分区：
文献类型：
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作者：
Bothun, Erick D.;Lynn, Michael J.;Lambert, Scott R.
目的：评估婴儿无晶状体眼治疗研究（IATS）中儿童的感觉运动结果。
方法：在这项比较原发性人工晶状体（IOL）或角膜接触镜（CL）矫正单侧无晶状体眼治疗的随机、多中心临床试验中进行了次要结果分析。对5岁以下儿童的眼位特征和感觉状态进行了评估。
结果：在IATS研究中，112名儿童中有91名（81%）在5岁时出现斜视。在白内障手术后近12个月眼位正位的34名婴儿中，5岁时14名（41%）远距离眼位正位，15名（44%）在5岁时近距离眼位正位且未进行斜视手术。角膜接触镜组56名儿童中有8名（14%），人工晶状体组56名中有13名（23%）在5岁时远距离眼位正位（P = 0.33）且无斜视手术史。48名在49天前接受白内障手术的儿童中有13名（27%），相比之下，64名在49天后手术的儿童中有8名（13%）眼位正位（P = 0.085）。正位或微小斜视（≤10△）儿童手术眼的中位视力为0.4 logMAR（20/50）（P = 0.0001）。21名正位儿童中有12名（57%）检测到立体视，而89名斜视儿童中有16名（18%）检测到立体视（P = 0.0006）。
结论：人工晶状体植入并不能减少单眼先天性白内障手术后斜视的发生。5岁时眼位改善与视力和立体视的提高密切相关。
PURPOSE 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(Delta) (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.