Secondary Analyses of data from the Infant Aphakia Treatment Study: Patching in Children with Unilateral Congenital Cataracts and Poor Visual Acuity

项目名称：婴儿无晶状体眼治疗研究数据的次要分析： 单侧先天性白内障与视力低下 项目总结：单侧先天性白内障（UCC）是儿科最困难的问题之一 眼科早期手术干预，以及一致的光学矫正和修补治疗， 这是必要的，以允许在这只眼睛中实现良好视力的可能性。目前，接受UCC治疗的儿童 建议在生命的前五年中，在清醒的时间内，将未受影响的眼睛贴上50%的眼罩，并且经常 一直到小学。即使早期手术和一致的修补这些眼睛相对较少 在孩子入学时发展出良好的视力。很大比例的儿童不 在治疗的眼睛中发展可用的视力，许多护理人员难以为他们的孩子修补眼睛。 规定的时间。因此，在注定视力不佳的眼睛中延长修补的效用是 目前尚不清楚，治疗的成本需要与可能的收益进行权衡。然而，很少有数据 关于如何帮助护理人员遵守规定的修补协议或帮助提供者， 护理人员确定何时这种修补的成本超过潜在的好处。这些差距 限制了治疗方案的制定，以满足这一人群的需求。因此， 可用于指导临床医生和护理人员决定提供多少修补的证据， 何时停止修补。 拟议项目将利用婴儿无晶状体治疗研究中收集的独特二级数据 （IATS），以便为建立可能改善结果的修补习惯提供指导。我们还将 进行分析，以便更好地了解在后半部分进行修补的成本和效益， 学龄前儿童接受UCC治疗。具体来说，我们将确定是否有可能准确地 使用收集到的信息，确定最终受影响眼睛几乎没有可用视力的儿童， 生命的前四年，如果生活质量受到儿童长期修补的影响， 看不清楚。 IATS是一项随机对照试验，旨在比较UCC的两种治疗方法： 无晶状体眼与白内障手术时植入眼内透镜（IOL）。主要研究是 目前最大的接受UCC治疗的儿童队列，并提供了重要的证据， 这些孩子在入学前的表现。拟议中的R21将利用来自这一独特的数据，以及- 接受UCC治疗的儿童的特征队列，这些儿童已随访超过10年， 关于UCC治疗相关重要问题的新知识。

Project Title: Secondary Analyses of data from the Infant Aphakia Treatment Study: Patching in Children with Unilateral Congenital Cataracts and Poor Visual Acuity Project Summary: Unilateral congenital cataracts (UCC) are one of the most difficult problems in pediatric ophthalmology. Early surgical intervention, and consistent optical correction and patching therapy are necessary to allow for the possibility of achieving good vision in this eye. Currently, children treated for UCC are advised to patch the unaffected eye for 50% of waking hours throughout the first five years of life, and often into the elementary school years. Even with early surgery and consistent patching relatively few of these eyes develop good visual acuity (VA) by the time the children enter school. A high proportion of children who do not develop useable vision in the treated eye and many caregivers have difficulty patching their children for the prescribed amount of time. Therefore, the utility of extended patching in eyes destined to have poor vision is unclear, and the costs of therapy need to be weighed against possible benefits. However, few data are available regarding how to help caregivers adhere to prescribed patching protocols or to help providers and caregivers determine when the costs of such patching outweigh the potential benefits. These gaps have limited the development of treatment protocols to address the needs of this population. Therefore, there is little evidence which can be used to guide clinicians and caregivers in deciding how much patching to provide and when to discontinue patching. The proposed project will leverage unique secondary data collected in the Infant Aphakia Treatment Study (IATS) in order to provide guidance on establishing patching habits that may improve outcomes. We will also conduct analyses that will improve understanding of the costs and benefits of patching in the latter part of the preschool period in children treated for UCC. Specifically, we will determine whether it is possible to accurately identify children who will ultimately have little usable vision in their affected eye using information collected in the first four years of life, and if quality of life is impacted by prolonged patching in children who ultimately will not see well. The IATS is a randomized controlled trial designed to compare two treatments for UCC: leaving children aphakic versus implanting an intraocular lens (IOL) at the time of cataract surgery. The primary study is one of the largest currently-available cohorts of children treated for UCC, and has provided important evidence about outcomes in these children prior to school-entry. The proposed R21 will leverage data from this unique, well- characterized cohort of children treated for UCC who have been followed for more than 10 years to generate new knowledge about important questions related to treatment of UCC.