Bothun Erick D, Lynn Michael J, Christiansen Stephen P, Neely Dan E, Vanderveen Deborah K, Kruger Stacey J, Lambert Scott R
Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
Department of Biostatistics and Bioinformations, Rollins School of Public Health, Emory University, Atlanta, Georgia.
J AAPOS. 2016 Feb;20(1):49-53. doi: 10.1016/j.jaapos.2015.11.002.
To evaluate sensorimotor outcomes among children in the Infant Aphakia Treatment Study (IATS).
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.
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(Δ)) versus 1.10 logMAR (20/252) for strabismus ≥10(Δ) (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).
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.
评估婴儿无晶状体治疗研究（IATS）中儿童的感觉运动结局。
在这项随机、多中心临床试验中进行了次要结局分析，该试验比较了用一期人工晶状体（IOL）或隐形眼镜（CL）矫正治疗单侧无晶状体的效果。评估了5岁以下儿童的眼位矫正特征和感觉状态。
在IATS研究中，112名儿童中有91名（81%）在5岁前出现斜视。在白内障手术后12个月时近距眼位正位的34名婴儿中，5岁时14名（41%）远距眼位正位，15名（44%）5岁时近距眼位正位且未接受斜视手术。CL组56名儿童中有8名（14%）、IOL组56名儿童中有13名（23%）在5岁时远距眼位正位（P = 0.33）且无斜视手术史。49日龄前接受白内障手术的48名儿童中有13名（27%）眼位正位，而49日龄后接受手术的64名儿童中有8名（13%）眼位正位（P = 0.085）。眼位正位或微小斜视（<10(Δ)）的儿童手术眼的平均视力为0.4 logMAR（20/50），而斜视≥10(Δ)的儿童为1.10 logMAR（20/252）（P = 0.0001）。21名眼位正位儿童中有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）。
单眼先天性白内障手术后植入IOL并不能减少斜视的发生。5岁时眼位矫正改善与视力和立体视改善密切相关。
