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Globe Axial Length Growth at Age 5 Years in the Infant Aphakia Treatment Study

M Edward Wilson1, Rupal H Trivedi1, David R Weakley2

  • 1Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina.

Ophthalmology
|February 16, 2017
PubMed

Insights

Infants with unilateral cataract surgery show similar axial length (AL) growth in operated eyes compared to fellow eyes. This growth was consistent across treatment types and did not correlate with visual outcomes, though it was higher in eyes with glaucoma or needing further surgery.

Area of Science:

  • Ophthalmology
  • Pediatric ophthalmology
  • Ophthalmic surgery

Background:

  • Congenital cataracts require early intervention, often involving surgery.
  • Understanding the long-term axial length (AL) growth in operated eyes is crucial for visual development.
  • Infantile aphakia presents unique challenges for refractive management and eye growth.

Purpose of the Study:

  • To track the longitudinal change in axial length (AL) from infancy to age 5 years after unilateral cataract surgery.
  • To compare the AL growth patterns between surgically treated eyes and their fellow unoperated eyes.
  • To analyze AL growth in relation to treatment modality (contact lens vs. intraocular lens) and visual outcomes.

Main Methods:

  • A comparative case series design was employed, analyzing data from the Infant Aphakia Treatment Study (IATS).
  • Axial length (AL) measurements were taken at baseline and up to age 5 years.
  • Statistical analyses compared AL changes between treated and fellow eyes, considering treatment type and presence of glaucoma.

Main Results:

  • Treated eyes had a significantly shorter AL preoperatively and at final follow-up compared to fellow eyes, but the AL growth difference was not significant (3.3 mm vs. 3.5 mm).
  • Axial length growth was similar between contact lens (CL) and intraocular lens (IOL) treatments (3.2 mm vs. 3.4 mm) and did not correlate with visual outcomes.
  • Eyes requiring additional surgery for visual axis opacification showed significantly greater AL growth (3.8 mm) than those that did not (2.7 mm). Patients with glaucoma exhibited the most significant eye growth (5.7 mm).

Conclusions:

  • Unilateral cataract surgery in infancy leads to comparable axial length (AL) growth in operated eyes relative to fellow eyes.
  • Axial length (AL) changes are consistent across different treatment modalities (CL and IOL) and do not predict visual outcomes.
  • Factors such as additional surgical procedures for visual axis opacification and the presence of glaucoma significantly influence axial length (AL) growth in these eyes.
Abstract

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