Predictors of adherence to occlusion therapy 3 months after cataract extraction in the Infant Aphakia Treatment Study

Drews‐Botsch, Carolyn; Hartmann, E. Eugenie; Celano, Marianne

doi:10.1016/j.jaapos.2011.12.149

Cited by 31 publications

(16 citation statements)

References 19 publications

(32 reference statements)

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“…Adherence was measured by using one of two report styles-either a 7-day prospective diary or a phone conversation requesting information on the previous 48 hours. In an earlier report, 18 we have shown that most caregivers describe being able to adhere to the prescribed occlusion treatment protocol within the first 3 months after surgery, and those parents whose child had private insurance report better adherence to the patching regimen. Additionally, an assessment of adherence to occlusion therapy in the first 6 months after cataract surgery and grating visual acuity at 12 months of age has demonstrated that better adherence results in better grating visual acuity.…”

Section: Discussionmentioning

confidence: 74%

Baseline Characteristics of the Infant Aphakia Treatment Study Population: Predicting Recognition Acuity at 4.5 Years of Age

Hartmann

Lynn

Lambert

2014

Investigative Ophthalmology & Visual Science

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This analysis concurs with previous studies that early surgery is important for good visual outcomes in patients with unilateral infantile cataracts. The fact that only one baseline variable (private insurance) contributed to the multivariate analysis, accounting for 12% of the variance, suggests that predicting visual outcome for these patients is complicated at best, and cannot be estimated from baseline characteristics alone. (ClinicalTrials.gov number, NCT00212134.).

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Section: Discussionmentioning

confidence: 74%

Baseline Characteristics of the Infant Aphakia Treatment Study Population: Predicting Recognition Acuity at 4.5 Years of Age

Hartmann

Lynn

Lambert

2014

Investigative Ophthalmology & Visual Science

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“…If the level of uncertainty is too high and consequently the self‐efficacy too low, there is an imminent risk of the parents giving up the occlusion therapy and use of lenses and developing a sense of complete parental failure. This is an undesirable consequence, as previous research shows that patching is crucial for the child's visual status (Charters, ; Dixon‐Woods, Awan, & Gottlob, ; Drews‐Botsch, Hartmann, & Celano, ; Lundvall & Kugelberg, ).…”

Section: Discussionmentioning

confidence: 99%

Uncertainty and self‐efficacy in parents of a child with congenital cataract—New implications for clinical practice

2019

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Aim The aim was an in‐depth exploration of uncertainty and self‐efficacy among parents of a child with congenital cataract by means of two theoretical frameworks to re‐design family care. Design A directed content analysis in accordance with Hsieh & Shannon, using Mishel's theory of uncertainty and Bandura's self‐efficacy theory. Methods Open‐ended, in‐depth interviews were conducted with 23 parents of a child with congenital cataract; six mothers, five fathers and six couples. Results In this novel study, self‐efficacy was interpreted as the ability to balance between uncertainty and acceptance. The performance accomplishment of the child and parents bridges the gap between uncertainty and acceptance by reducing uncertainty, thus constituting the level of self‐efficacy. Setbacks and complications increase uncertainty and reduce self‐efficacy, thus performance accomplishment is a mediator of self‐efficacy, while ability to master uncertainty determines the level of self‐efficacy.

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“…We previously found that, in the first year after surgery, adherence to patching was associated with sociodemographic factors but not IOL implantation 11 and that adherence to patching in the first 6 months after surgery was associated with grating acuity at 12 months of age. 12 However, visual acuity measured behaviorally is not strongly predictive of optotype acuity. 13 Furthermore, adherence to patching may become more challenging as children begin to resist patching.…”

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confidence: 99%

Association Between Occlusion Therapy and Optotype Visual Acuity in Children Using Data From the Infant Aphakia Treatment Study

et al. 2016

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for the Infant Aphakia Treatment Study Group IMPORTANCE Patching has been a mainstay in treating unilateral congenital cataract. However, its efficacy has not been rigorously assessed.OBJECTIVE To examine the association between patching and visual acuity in a cohort of children treated for unilateral congenital cataract. DESIGN, SETTING, AND PARTICIPANTSThis study was a secondary analysis of a randomized clinical trial (Infant Aphakia Treatment Study) of infants born from August 1, 2004, through December 31, 2008, who were treated with 1 of 2 treatments for unilateral congenital cataract and followed up to 5 years of age. Data analysis was performed from March 1, 2013, to March 1, 2016.INTERVENTIONS Cataract extraction and randomization to receipt of an intraocular lens vs being left aphakic for the first 5 years of life. MAIN OUTCOMES AND MEASURESCaregivers reported patching in the previous 48 hours in quarterly semistructured telephone interviews. The mean number of hours of patching per day was calculated from surgery to the first birthday (n = 92) and between 12 and 48 months of age (n = 102). Monocular optotype acuity was assessed at 4½ years of age by a traveling examiner using the Aphakia Treatment Study HOTV protocol. RESULTSThe Infant Aphakia Treatment Study enrolled 114 children; 57 were randomized to each treatment group. At 4½ years of age, optotype visual acuity was assessed in 112 children. The current analyses exclude an additional 3 children (2 who had adverse events that limited visual potential and 1 who had Stickler syndrome), leaving 109 total children analyzed (59 female [54.1%] and 92 white [84.4%]). Caregivers reported patching their children a mean (SD) of 3.73 (1.47) hours per day in the first year of life and 3.43 (2.04) hours per day thereafter. An association between reported patching and treatment was not identified (mean difference in first year, −0.29 hours per day; 95% CI, −0.90 to 0.33 hours per day; mean difference between 12 and 48 months of age, −0.40 hours per day; 95% CI, −1.20 to 0.40 hours per day). Visual acuity was associated with reported hours of patching in the first year of life (r = −0.32; 95% CI, −0.49 to −0.13) and between 12 and 48 months of age (r = −0.36; 95% CI, −0.52 to −0.18). However, patching accounted for less than 15% of the variance in logMAR acuity at 4½ years of age. CONCLUSIONS AND RELEVANCEThese results support the association of occlusion throughout the preschool years with improved visual acuity in infants treated for unilateral congenital cataract. However, similar visual outcomes were achieved with varying amounts of patching. These conclusions should be interpreted in the context of limitations related to generalizability from incomplete data collected in a clinical trial. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00212134

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Predictors of adherence to occlusion therapy 3 months after cataract extraction in the Infant Aphakia Treatment Study

Cited by 31 publications

References 19 publications

Baseline Characteristics of the Infant Aphakia Treatment Study Population: Predicting Recognition Acuity at 4.5 Years of Age

Baseline Characteristics of the Infant Aphakia Treatment Study Population: Predicting Recognition Acuity at 4.5 Years of Age

Uncertainty and self‐efficacy in parents of a child with congenital cataract—New implications for clinical practice

Association Between Occlusion Therapy and Optotype Visual Acuity in Children Using Data From the Infant Aphakia Treatment Study

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