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Spectacle Adherence Among Four-Year-Old Children in the Infant Aphakia Treatment Study
Scott R Lambert1, Lindreth DuBois2, George Cotsonis3
1Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA.
Insights
High spectacle adherence is possible in young children post-cataract surgery. However, children with poorer vision in their treated eye showed the lowest adherence, despite needing eye protection most.
Area of Science:
- Ophthalmology
- Pediatric ophthalmology
- Clinical research
Background:
- Unilateral cataract surgery in infancy requires effective visual rehabilitation.
- Spectacle wear is crucial for visual development and protection in children.
- Assessing adherence to spectacle correction is vital for treatment success.
Purpose of the Study:
- To evaluate spectacle adherence with impact-resistant lenses in 4-year-old children following unilateral cataract surgery.
- To identify factors influencing spectacle adherence in this pediatric population.
Main Methods:
- Retrospective cohort analysis of data from the Infant Aphakia Treatment Study.
- Involved 114 children randomized to contact lens or intraocular lens correction.
- Spectacle adherence assessed via diaries and interviews up to age 5 years.
Main Results:
- Children with better vision (20/40 or better) in the treated eye were more likely to achieve high spectacle adherence (≥80% wear).
- Spectacle adherence correlated positively with patching adherence.
- No correlation found between adherence and sex, insurance type, or refractive error.
Conclusions:
- High spectacle adherence can be achieved in young children after unilateral cataract surgery.
- Children with poorer vision in the treated eye exhibited the lowest adherence rates.
- Targeted interventions may be needed for children with suboptimal vision to improve adherence and eye protection.
Purpose:
To evaluate spectacle adherence with impact-resistant lenses among 4-year-old children after unilateral cataract surgery in the Infant Aphakia Treatment Study.
Design:
Retrospective cohort analysis of randomized clinical trial data.
Methods:
Setting: Multicenter.
Patients:
One hundred and fourteen children randomized to contact lens correction or intraocular lens implantation following unilateral cataract surgery during infancy.
Intervention:
One-week diaries completed annually and retrospective telephone interviews conducted every 3 months to age 5 years to assess spectacle adherence with impact-resistant lenses. Visual acuity was assessed by a traveling examiner at age 4.5 years.
Main Outcome Measures:
Spectacle adherence between ages 4 and 5 years.
Results:
Children with 20/40 or better vision in their treated eye were more likely to wear spectacles ≥80% of their waking hours than children with vision worse than 20/40 (66% vs 42%, P = .034). Reported adherence to spectacle wear correlated with reported patching (r = 0.30, P = .002). Spectacle adherence did not correlate with sex, type of healthcare insurance, or the refractive error in the treated or fellow eye. Seven patients with reduced vision in their treated eye reported <10% spectacle adherence.
Conclusions:
These results confirm that it is possible to achieve high levels of spectacle adherence among 4-year-old children after unilateral cataract surgery during infancy. However, children with vision worse than 20/40 in their worse eye, who needed eye protection the most, had the worst adherence.
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