Association of Contact Lens Adherence With Visual Outcome in the Infant Aphakia Treatment Study

Cromelin, Caroline H.; Drews‐Botsch, Carolyn; Russell, Buddy; Lambert, Scott R.

doi:10.1001/jamaophthalmol.2017.6691

Cited by 15 publications

(7 citation statements)

References 18 publications

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“…In the aphakia group, mean reported adherence to contact lens wear and patching therapy from the age of 4 to 5 years was compared between patients who continued to wear contact lenses and those who did not using an independent group t test. Adherence to contact lens use and patching therapy was assessed using caregiver adherence interviews . All reported P values are 2-sided without adjustment for multiple testing.…”

Section: Methodsmentioning

confidence: 99%

Long-term Effect of Intraocular Lens vs Contact Lens Correction on Visual Acuity After Cataract Surgery During Infancy

et al. 2020

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IMPORTANCEAlthough intraocular lenses (IOLs) are often implanted in children, little is known whether primary IOL implantation or aphakia and contact lens correction results in better long-term visual outcomes after unilateral cataract surgery during infancy.OBJECTIVE To compare long-term visual outcomes with contact lens vs IOL correction following unilateral cataract surgery during infancy. DESIGN, SETTING, AND PARTICIPANTSThis multicenter randomized clinical trial enrolled 114 infants with a unilateral congenital cataract who underwent cataract surgery with or without primary IOL implantation between 1 and 6 months of age. Data on long-term visual outcomes were collected when the children were age 10.5 years (July 14, 2015, to July 12, 2019 and analyzed from March 30 through August 6, 2019. INTERVENTIONS Intraocular lens implantation at the time of cataract surgery.MAIN OUTCOMES AND MEASURES Best-corrected visual acuity using the electronic Early Treatment Diabetic Retinopathy Study (E-ETDRS) testing protocol. Analysis was performed on an intention-to-treat basis.RESULTS Best-corrected visual acuity was measured at age 10.5 years for 110 of the 114 patients (96%) enrolled as infants. The participants included 58 girls (53%) and 52 boys (47%). Overall, 27 of the children (25%) had good (logMAR 0.30 [Snellen equivalent, 20/40] or better) visual acuity in the treated eye (12 [22%] in the IOL group and 15 [27%] in the aphakia group), but 50 children (44%) had a visual acuity of logMAR 1.00 (Snellen equivalent, 20/200) or worse (25 [44%] in the IOL group and 25 [44%] in the aphakia group). The median logMAR acuity in the treated eye was similar in children randomized to receive an IOL at the time of cataract extraction (0.89; interquartile range [IQR], 0.33-1.43 [Snellen equivalent, 20/159]) and those who remained aphakic (0.86; IQR, 20/145]) (IQR, 0.30-1.46; P = .82). Although the overall difference in median visual acuity between the 2 groups was small, the estimate was imprecise (99% CI for the difference in medians was −0.54 to 0.47). CONCLUSIONS AND RELEVANCEAs in previous phases of the study, visual acuity outcomes were highly variable with only 27 children (25%) achieving excellent visual acuity in their treated eye and 50 children (44%) having poor vision in the treated eye. Implanting an IOL at the time of cataract extraction was neither beneficial nor detrimental to the visual outcome.

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Section: Methodsmentioning

confidence: 99%

Long-term Effect of Intraocular Lens vs Contact Lens Correction on Visual Acuity After Cataract Surgery During Infancy

et al. 2020

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“…A report of corneal changes in children after unilateral cataract surgery in the Infant Aphakia Treatment Study (IATS) found endothelial cell density and central corneal thickness were less favourable for infants treated with aphakic contact lenses compared to those treated with intraocular lenses at the 5-year outcome examination [695], but the long term implications remain unknown. In a secondary analysis, the IATS found that children who wore contact lenses for a larger amount of their waking hours in a day throughout the study period of 5 years had better visual outcomes, even after accounting for patching adherence [696].…”

Section: Paediatric Aphakiamentioning

confidence: 96%

BCLA CLEAR – Medical use of contact lenses

Jacobs

Carrasquillo²,

Cottrell

et al. 2021

Contact Lens and Anterior Eye

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The medical use of contact lenses is a solution for many complex ocular conditions, including high refractive error, irregular astigmatism, primary and secondary corneal ectasia, disfiguring disease, and ocular surface disease. The development of highly oxygen permeable soft and rigid materials has extended the suitability of contact lenses for such applications. There is consistent evidence that bandage soft contact lenses, particularly silicone hydrogel lenses, improve epithelial healing and reduce pain in persistent epithelial defects, after trauma or surgery, and in corneal dystrophies. Drug delivery applications of contact lens hold promise for improving topical therapy. Modern scleral lens practice has achieved great success for both visual rehabilitation and therapeutic applications, including those requiring retention of a tear reservoir or protection from an adverse environment. This report offers a practical and relevant summary of the current evidence for the medical use of contact lenses for all eye care professionals including optometrists, ophthalmologists, opticians, and orthoptists. Topics covered include indications for use in both acute and chronic conditions, lens selection, patient selection, wear and care regimens, and recommended aftercare schedules. Prevention, presentation, and management of complications of medical use are reviewed.

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“…11 Most experts thus discourage the implementation of IOLs for infants younger than 2 years, who are better visually assisted with contact lenses, especially when they suffer from unilateral aphakia. [12][13][14] Nowadays, contact lenses are the prevalent solution for unilateral congenital cataract correction in North America, 15,16 despite the challenges they present, such as poor cooperation in lens handling, high rate of lens loss, difficulty in lens fitting for infants with inaccurate keratometry measures (which is impossible to measure in infants because of limitations of measurement in this population), and potential risk of bacterial keratitis, which may reduce the chance to achieve an excellent visual outcome. 17,18 This study investigated a number of patients referred for contact lens fitting to the Contact Lens Clinic at Farabi Eye Hospital, having undergone lensectomy and anterior vitrectomy at another eye hospital in Iran.…”

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confidence: 99%

Experiences of Treatment With Contact Lenses in Aphakic Children With Unilateral Congenital Cataract: A Retrospective Study

Kooshki¹,

Kooshki²,

Yaseri³

et al. 2022

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Background and Objectives:Congenital cataract is a condition compromising the eye's crystalline lens in infants and is usually diagnosed at birth. It can lead to irreversible vision loss if not promptly detected and treated, especially in unilateral cases. Nowadays, children with congenital cataracts can undergo surgical removal of their opacified crystalline lenses, and visual rehabilitation is mandatory to prevent deep amblyopia. Contact lenses, predominantly of rigid gas-permeable (GP) type, are gaining more popularity for this matter.Method:In this retrospective cohort study, unilateral aphakic children younger than 6 years referred to the Contact Lens Clinic at Farabi Eye Hospital from November 2011 to September 2019 were included.Results:Seventy-six unilateral aphakic children with congenital cataracts (57.9% boys and 42.1% girls) rehabilitated with GP were studied. The mean age of diagnosis and referral to the contact lens clinic were 20.0±19.8 and 32.0±24.4 weeks, respectively, while the mean follow-up time was 12.44±26.28 months. The mean visual acuity for children capable of cooperating at the last follow-up was 0.98±0.62 log MAR. Among the participants, eight children (9.7%) were diagnosed as glaucoma suspects. The mean initial base curve and power of GP lenses were 7.86±0.39 mm and 23.29±5.52 diopters, respectively. Only 21 parents (27.6%) reported nonadherence to the scheduled part-time patch program.Conclusion:The results of this study showed GP-based optical treatment after early diagnosis, surgical removal of congenital cataracts, and a long-term close follow-up to be well tolerated by children and their parents, with acceptable parents' compliance and can thus be introduced as a safe and effective method to achieve desirable visual outcomes.

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Association of Contact Lens Adherence With Visual Outcome in the Infant Aphakia Treatment Study

Cited by 15 publications

References 18 publications

Long-term Effect of Intraocular Lens vs Contact Lens Correction on Visual Acuity After Cataract Surgery During Infancy

Long-term Effect of Intraocular Lens vs Contact Lens Correction on Visual Acuity After Cataract Surgery During Infancy

BCLA CLEAR – Medical use of contact lenses

Experiences of Treatment With Contact Lenses in Aphakic Children With Unilateral Congenital Cataract: A Retrospective Study

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