Drews-Botsch Carolyn, Hartmann E Eugenie, Celano Marianne, Zaidi Jaffer, Lambert Scott R
Department of Global and Community Health, George Mason University, Fairfax, Virginia.
Vision Center and Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, Ohio.
Ophthalmology. 2025 May;132(5):561-568. doi: 10.1016/j.ophtha.2024.12.036. Epub 2024 Dec 28.
Achieving near normal vision after unilateral congenital cataract (UCC) surgery is possible but requires early surgery, optical correction, and consistent patching. Patching is often challenging for children and their caregivers. The goal of these analyses is to examine the association between reported consistency in patching during the first year after surgery and visual acuity (VA).
Data from the Infant Aphakia Treatment Study (IATS) are used in a cohort design.
A total of 101 children whose caregivers completed a prospective, 7-day patching diary 2 months after surgery or at 13 months of age.
Consistent patching was defined as patching every day and either an average patch start time before 9:00 am or the interquartile range of the first time a patch was applied of 60 minutes or less.
Recognition VA was assessed at ages 54+ 1 months and 10.5 years. Near normal VA was defined as VA of 20/40 or better.
Diary data were available for 101 children. Overall, 55% of children whose caregivers reported consistent patching at age 13 months had near normal vision at age 54 + 1 months and 45% had near normal vision at age 10.5 years compared with 14% and 19%, respectively, when caregivers reported less consistent patching (adjusted relative risk at 54 months of age 3.55, 95% confidence interval [CI], 1.61-7.80; adjusted relative risk at 10.5 years of age 2.31, 95% CI, 1.12-4.78).
Consistent patching in the first year after surgery for UCC is associated with better VA. These findings can be used to provide evidence-based guidance to caregivers to help improve VA outcomes for their children.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
单侧先天性白内障（UCC）手术后实现接近正常的视力是有可能的，但需要早期手术、光学矫正和持续的遮盖治疗。对于儿童及其照料者而言，遮盖治疗往往颇具挑战性。这些分析的目的是研究术后第一年报告的遮盖治疗一致性与视力（VA）之间的关联。
采用队列设计，使用来自婴儿无晶状体治疗研究（IATS）的数据。
共有101名儿童，其照料者在术后2个月或13个月大时完成了一份前瞻性的7天遮盖治疗日记。
持续遮盖治疗定义为每天进行遮盖，且平均遮盖开始时间在上午9:00之前，或者首次进行遮盖的四分位间距为60分钟或更短。
在54±1个月和10.5岁时评估识别视力。接近正常视力定义为视力20/40或更好。
有101名儿童的日记数据可用。总体而言，其照料者报告在13个月大时持续进行遮盖治疗的儿童中，55%在54±1个月时视力接近正常，45%在10.5岁时视力接近正常；相比之下，当照料者报告遮盖治疗一致性较差时，这两个年龄段的比例分别为14%和19%（54个月龄时调整后的相对风险为3.55，95%置信区间[CI]为1.61 - 7.80；10.5岁时调整后的相对风险为2.31，95%CI为1.12 - 4.78）。
UCC手术后第一年的持续遮盖治疗与更好的视力相关。这些发现可用于为照料者提供循证指导，以帮助改善其子女的视力结果。
作者对本文讨论的任何材料均无所有权或商业利益。
