Five-Year Postoperative Outcomes of Bilateral Aphakia and Pseudophakia in Children up to 2 Years of Age: A Randomized Clinical Trial

Vasavada, Abhay R.; Shah, Sajani K.; Praveen, Mamidipudi R.; Vasavada, Vaishali; Trivedi, Rupal H.; Rawat, Farida; Koul, Archana

doi:10.1016/j.ajo.2018.06.005

Cited by 58 publications

(112 citation statements)

References 54 publications

Supporting

Mentioning

102

Contrasting

Unclassified

Order By: Relevance

“…These results are consistent with the 5-year IATS results (31% pseudophakic and 17% aphakic eyes). 14 Vasavada et al 29 reported glaucoma in 16% of aphakic eyes and 14% of pseudophakic eyes at 5 years of age. The IoLunder2 study described glaucoma or persistent ocular hypertension in 23% of aphakic eyes and 10% of pseudophakic eyes.…”

Section: Discussionmentioning

confidence: 98%

“…6 Two recent series including bilateral cataracts have been reported in children younger than 2 years, one by a single surgeon in India and a second from a consortium of surgeons in the United Kingdom and Ireland (IoLunder2). 18e20, 29 Limitations of these studies in determining the effect of age on complications and AEs include the empirical grouping of children from birth to 24 months of age and, more importantly, the nonstandardized surgical techniques in the group of 63 surgeons in the United Kingdom group. The participating surgeons in the TAPS were consistent in their documentation, clinical care, and surgical practice with IATS surgeons.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of Bilateral Cataracts Removed in Infants 1 to 7 Months of Age Using the Toddler Aphakia and Pseudophakia Treatment Study Registry

et al. 2020

Self Cite

View full text Add to dashboard Cite

To evaluate outcomes of bilateral cataract surgery in infants 1 to 7 months of age performed by Infant Aphakia Treatment Study (IATS) investigators during IATS recruitment and to compare them with IATS unilateral outcomes.Design: Retrospective case series review at 10 IATS sites.Participants: The Toddler Aphakia and Pseudophakia Study (TAPS) is a registry of children treated by surgeons who participated in the IATS.Methods: Children underwent bilateral cataract surgery with or without intraocular lens (IOL) placement during IATS enrollment years 2004 through 2010.Main Outcome Measures: Visual acuity (VA), strabismus, adverse events (AEs), and reoperations.Results: One hundred seventy-eight eyes (96 children) were identified with a median age of 2.5 months (range, 1e7 months) at the time of cataract surgery. Forty-two eyes (24%) received primary IOL implantation. Median VA of the better-seeing eye at final study visit closest to 5 years of age with optotype VA testing was 0.35 logarithm of the minimum angle of resolution (logMAR; optotype equivalent, 20/45; range, 0.00e1.18 logMAR) in both aphakic and pseudophakic children. Corrected VA was excellent (<20/40) in 29% of better-seeing eyes, 15% of worse-seeing eyes. One percent showed poor acuity (20/200) in the better-seeing eye, 12% in the worse-seeing eye. Younger age at surgery and smaller (<9.5 mm) corneal diameter at surgery conferred an increased risk for glaucoma or glaucoma suspect designation (younger age: odds ratio [OR], 1.44; P ¼ 0.037; and smaller cornea: OR, 3.95; P ¼ 0.045). Adverse events also were associated with these 2 variables on multivariate analysis (younger age: OR, 1.36; P ¼ 0.023; and smaller cornea: OR, 4.78; P ¼ 0.057). Visual axis opacification was more common in pseudophakic (32%) than aphakic (8%) eyes (P ¼ 0.009). Unplanned intraocular reoperation occurred in 28% of first enrolled eyes (including glaucoma surgery in 10%).Conclusions: Visual acuity after bilateral cataract surgery in infants younger than 7 months is good, despite frequent systemic and ocular comorbidities. Although aphakia management did not affect VA outcome or AE incidence, IOL placement increased the risk of visual axis opacification. Adverse events and glaucoma correlated with a younger age at surgery and glaucoma correlated with the presence of microcornea. Ophthalmology 2020;127:501-510 ª 2019 by the American Academy of Ophthalmology Supplemental material available at www.aaojournal.org. MethodsThis study was approved by the institutional review board or ethics review board at all participating institutions (Mayo Clinic,

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Outcomes of Bilateral Cataracts Removed in Infants 1 to 7 Months of Age Using the Toddler Aphakia and Pseudophakia Treatment Study Registry

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…The outcome measure was defined as the long-term secondary glaucoma rate, which means glaucoma developed at least one year after cataract surgery. The diagnosis criteria of secondary glaucoma from included studies varies, most of which made the diagnosis by elevated IOP (over 21mmHg) in 2 to 3 random tests plus one or more of the following combination signs: (1) optic disc cupping �0.3/ asymmetry �0.2/progression, (2)corneal changes, (3)progressive myopia shift [11][12][13][14][15][16][17], while the other study diagnosed glaucoma only if the patients with elevated IOP tested 2 to 3 times randomly [18]. If there was more than one published report on the same population or group of patients, the most recent results with complementary data from previous articles were used for the statistical analysis.…”

Section: Outcome Measuresmentioning

confidence: 99%

The role of primary intraocular lens implantation in the risk of secondary glaucoma following congenital cataract surgery: A systematic review and meta-analysis

Zhang

Wang

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

This meta-analysis aims to evaluate the incidence of secondary glaucoma in patients under the age of 2 years who underwent congenital cataract surgery with or without primary intraocular lens (IOL) implantation. Methods An electronic literature search was performed in Medline, EMBASE, and Web of Science databases to retrieve studies between January 2011 and November 2018. Patients with congenital cataract who did primary IOL implantation, aphakia, or secondary IOL implantation followed by receiving extraction surgery were included in this study. Relevant studies meeting defined eligibility criteria were selected and reviewed systematically by meta-analysis. Long-term incidences of secondary glaucoma, which developed at least one year after cataract surgery, were considered and discussed as clinical outcomes in each cohort. The pooled data were analyzed according to a random effects model. Results Eight publications involving 892 eyes were included in the current meta-analysis. In the general population of eyes with congenital cataract, the long-term incidence of secondary glaucoma was lower (P = 0.06) in eyes with primary IOL (9.5%) than in eyes without primary IOL (15.1%), including aphakia and secondary IOL. The pooled risk ratio (RR) favors primary IOL implantation in all patients (RR = 0.63). For bilateral congenital cataract, the incidence was 6.7% in eyes with primary IOL implantation, which is significantly lower than the 16.7%

show abstract

“…Congenital cataracts (CCs) are now the most common avoidable cause of childhood blindness worldwide, accounting for 10–35% of such cases, with an estimated incidence of 0.63–9.14/10,000 births [ 1 – 4 ]. Management is often difficult due to the risk of amblyopia in the developing visual system and complications of glaucoma, posterior synechia or visual axis opacification, which require additional surgery [ 5 ]. CCs occur due to the disruption of the lens microarchitecture or the protein function in the lens [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The mutation spectrum in familial versus sporadic congenital cataract based on next-generation sequencing

Fan

Luo

et al. 2020

BMC Ophthalmol

View full text Add to dashboard Cite

Background: Congenital cataract (CC) is a significant cause of lifelong visual loss, and its genetic diagnosis is challenging due to marked genetic heterogeneity. The purpose of this article is to report the genetic findings in sporadic and familial CC patients. Methods: Patients (n = 53) who were clinically diagnosed with CC and their parents were recruited. Blood samples were collected in our hospital. Mutations were detected by panel-based next-generation DNA sequencing (NGS) targeting 792 genes frequently involved in common inherited eye diseases. Results: We identified variants in 10/37 cases (27.02%) of sporadic CC and 14/16 cases (87.5%) of familial CC, which indicated a significant difference (P = 0.000). Of the 13 variants identified in sporadic cases, nine were previously reported mutations, and three were novel mutations, including one de novo mutation (CRYBB2 c.487C > T). The most frequent variants in our cohort were in crystallins and cytoskeletal genes (5/27, 18.52%), followed by proteins associated with X-linked syndromic conditions (14.81%) and transcriptional factors (11.11%). Additional information on the possibility of complications with inherited ocular or systemic diseases other than CC was provided in 17/27 (62.96%) variants. Conclusions: These results contribute to expanding the mutation spectrum and frequency of genes responsible for CC. Targeted NGS in CC provided significant diagnostic information and enabled more accurate genetic counselling. This study reports the different distributions of mutation genes in familial and sporadic CC cases.

show abstract

Five-Year Postoperative Outcomes of Bilateral Aphakia and Pseudophakia in Children up to 2 Years of Age: A Randomized Clinical Trial

Cited by 58 publications

References 54 publications

Outcomes of Bilateral Cataracts Removed in Infants 1 to 7 Months of Age Using the Toddler Aphakia and Pseudophakia Treatment Study Registry

Outcomes of Bilateral Cataracts Removed in Infants 1 to 7 Months of Age Using the Toddler Aphakia and Pseudophakia Treatment Study Registry

The role of primary intraocular lens implantation in the risk of secondary glaucoma following congenital cataract surgery: A systematic review and meta-analysis

The mutation spectrum in familial versus sporadic congenital cataract based on next-generation sequencing

Contact Info

Product

Resources

About