Weakley David, Cotsonis George, Wilson M Edward, Plager David A, Buckley Edward G, Lambert Scott R
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas.
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Am J Ophthalmol. 2017 Aug;180:1-7. doi: 10.1016/j.ajo.2017.05.008. Epub 2017 May 17.
To report the prevalence of anisometropia at age 5 years after unilateral intraocular lens (IOL) implantation in infants.
Prospective randomized clinical trial.
Fifty-seven infants in the Infant Aphakia Treatment Study (IATS) with a unilateral cataract were randomized to IOL implantation with an initial targeted postoperative refractive error of either +8 diopters (D) (infants 28 to <48 days of age) or +6 D (infants 48-210 days of age). Anisometropia was calculated at age 5 years. Six patients were excluded from the analyses.
Median age at cataract surgery was 2.2 months (interquartile range [IQR], 1.2, 3.5 months). The mean age at the age 5 years follow-up visit was 5.0 ± 0.1 years (range, 4.9-5.4 years). The median refractive error at the age 5 years visit of the treated eyes was -2.25 D (IQR -5.13, +0.88 D) and of the fellow eyes +1.50 D (IQR +0.88, +2.25). Median anisometropia was -3.50 D (IQR -8.25, -0.88 D); range -19.63 to +2.75 D. Patients with glaucoma in the treated eye (n = 9) had greater anisometropia (glaucoma, median -8.25 D; IQR -11.38, -5.25 D vs no glaucoma median -2.75; IQR -6.38, -0.75 D; P = .005).
The majority of pseudophakic eyes had significant anisometropia at age 5 years. Anisometropia was greater in patients that developed glaucoma. Variability in eye growth and myopic shift continue to make refractive outcomes challenging for IOL implantation during infancy.
报告婴儿单侧人工晶状体（IOL）植入术后5岁时屈光参差的患病率。
前瞻性随机临床试验。
婴儿无晶状体治疗研究（IATS）中57名单侧白内障婴儿被随机分为IOL植入组，初始目标术后屈光不正为+8屈光度（D）（28至<48日龄婴儿）或+6 D（48 - 210日龄婴儿）。在5岁时计算屈光参差。6名患者被排除在分析之外。
白内障手术的中位年龄为2.2个月（四分位间距[IQR]，1.2，3.5个月）。5岁随访时的平均年龄为5.0±0.1岁（范围，4.9 - 5.4岁）。治疗眼在5岁时的中位屈光不正为-2.25 D（IQR -5.13，+0.88 D），对侧眼为+1.50 D（IQR +0.88，+2.25）。中位屈光参差为-3.50 D（IQR -8.25，-0.88 D）；范围为-19.63至+2.75 D。治疗眼患有青光眼的患者（n = 9）屈光参差更大（青光眼，中位-8.25 D；IQR -11.38，-5.25 D，无青光眼为中位-2.75；IQR -6.38，-0.75 D；P = .005）。
大多数人工晶状体眼在5岁时存在明显的屈光参差。发生青光眼的患者屈光参差更大。眼球生长的变异性和近视漂移继续使婴儿期IOL植入的屈光结果具有挑战性。
