VanderVeen Deborah K, Drews-Botsch Carolyn D, Nizam Azhar, Bothun Erick D, Wilson Lorri B, Wilson M Edward, Lambert Scott R
From the Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School (VanderVeen), Boston, Massachusetts, Department of Epidemiology (Drews-Botsch), Department of Biostatistics and Bioinformatics (Nizam), Rollins School of Public Health, Emory University, Atlanta, Georgia, Department of Ophthalmology, Mayo Clinic (Bothun), Rochester, Minnesota, Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University School of Medicine (L.B. Wilson), Portland, Oregon, Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina (M.E. Wilson), Charleston, South Carolina, Department of Ophthalmology, Stanford University School of Medicine (Lambert), Stanford, California, USA.
J Cataract Refract Surg. 2021 Feb 1;47(2):172-177. doi: 10.1097/j.jcrs.0000000000000412.
To report outcomes of secondary intraocular lens (IOL) implantation in the Infant Aphakia Treatment Study (IATS).
Multicenter clinical practice.
Secondary analysis of patients enrolled in a randomized clinical trial.
Details regarding all secondary IOL surgeries conducted in children enrolled in the IATS were compiled. Visual outcomes, refractive outcomes, and adverse events at the age of 10½ years were evaluated. Comparisons were made with eyes that remained aphakic and with eyes randomized to primary IOL placement.
The study included 114 infants, 57 in the aphakic group and 57 in the primary IOL group; 55 of 57 patients randomized to aphakia with contact lens correction were seen for the 10½-year study visit; 24 (44%) of 55 eyes had secondary IOL surgery. Median age at IOL surgery was 5.4 years (range 1.7 to 10.3 years). Mean absolute prediction error was 1.00 ± 0.70 diopters (D). At age 10½ years, the median logarithm of the minimum angle of resolution visual acuity (VA) was 0.9 (range 0.2 to 1.7), similar to VA in the 31 eyes still aphakic (0.8, range 0.1 to 2.9); the number of eyes with stable or improved VA scores between the 4½-year and 10½-year study visits was also similar (78% secondary IOL eyes; 84% aphakic eyes). For eyes undergoing IOL implantation after the 4½-year study visit (n = 22), the mean refraction at age 10½ years was -3.20 ± 2.70 D (range -9.90 to 1.10 D), compared with -5.50 ± 6.60 D (n = 53, range -26.50 to 3.00 D) in eyes with primary IOL (P = .03).
Delayed IOL implantation allows a more predictable refractive outcome at age 10½ years, although the range of refractive error is still large.
报告婴儿无晶状体治疗研究（IATS）中二期人工晶状体（IOL）植入的结果。
多中心临床实践。
对参与一项随机临床试验的患者进行二次分析。
汇总IATS中纳入的儿童所进行的所有二期IOL手术的详细信息。评估10.5岁时的视力结果、屈光结果和不良事件。与仍为无晶状体眼以及随机接受一期IOL植入的眼进行比较。
该研究纳入114名婴儿，无晶状体组57名，一期IOL组57名；随机分配至无晶状体并接受角膜接触镜矫正的57名患者中，55名接受了10.5年的研究随访；55眼中24眼（44%）接受了二期IOL手术。IOL手术的中位年龄为5.4岁（范围1.7至10.3岁）。平均绝对预测误差为1.00±0.70屈光度（D）。在10.5岁时，最小分辨角视力（VA）对数的中位数为0.9（范围0.2至1.7），与31只仍为无晶状体的眼（0.8，范围0.1至2.9）相似；在4.5年和10.5年研究随访之间VA评分稳定或改善的眼数也相似（二期IOL眼为78%；无晶状体眼为84%）。对于在4.5年研究随访后接受IOL植入的眼（n = 22），10.5岁时的平均屈光度为-3.20±2.70 D（范围-9.90至1.10 D），而一期IOL眼为-5.50±6.60 D（n = 53，范围-26.50至3.00 D）（P = 0.03）。
延迟IOL植入在10.5岁时可使屈光结果更可预测，尽管屈光不正范围仍较大。
