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Globe Axial Length Growth at Age 10.5 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, USA.
Insights
Infant cataract surgery did not alter overall axial length (AL) growth compared to fellow eyes. Treated eyes showed similar growth whether treated with contact lenses (CL) or intraocular lenses (IOL), though glaucoma impacted AL growth.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Ophthalmic Surgery
Background:
- Unilateral cataract surgery in infants requires monitoring of axial length (AL) growth.
- The Infant Aphakia Treatment Study provides long-term data on visual development and ocular growth.
Purpose of the Study:
- To track changes in globe axial length (AL) from infancy to age 10.5 years after unilateral cataract surgery.
- To compare AL growth between operated and fellow unoperated eyes in infants.
Main Methods:
- A comparative case series design was used.
- Axial length growth was analyzed based on treatment type (contact lens vs. intraocular lens), visual acuity outcomes, and need for secondary surgery.
- Eyes with glaucoma were analyzed separately.
Main Results:
- Treated eyes were shorter preoperatively and at age 10.5 but exhibited similar AL growth (4.7 mm) to fellow eyes (P = .99).
- Axial length growth was comparable between contact lens and intraocular lens groups (P = .79).
- Eyes with glaucoma showed significantly greater growth (7.3 mm) compared to non-glaucomatous eyes (4.7 mm).
Conclusions:
- Unilateral cataract surgery in infants does not significantly alter overall axial length growth compared to fellow eyes.
- Axial length growth was similar for both contact lens and intraocular lens treatments.
- Glaucoma and poor visual acuity were associated with increased axial length growth in operated eyes.
Purpose:
To report the change in globe axial length (AL) from the time of unilateral cataract surgery at age 1-7 months to age 10.5 years for infants enrolled in the Infant Aphakia Treatment Study, and to compare AL growth of operated eyes with that of fellow unoperated eyes.
Design:
Comparative case series.
Methods:
AL growth was analyzed relative to treated vs fellow eye, contact lens (CL) vs intraocular lens (IOL), visual acuity (VA) outcome, and the need for surgery for visual axis opacification. Eyes with glaucoma or glaucoma suspect were excluded from the primary analysis but reported separately.
Results:
Fifty-seven patients have reliable AL data available at both visits. AL was shorter in treated eyes preoperatively (P < .0001) and at 10.5 years of age (P = .021) but AL growth was not different (4.7 mm, P = .99). The growth (70.2% up to age 5 and 29.8% from age 5 to 10.5) was similar in the CL and the IOL group (P = .79). Eyes grew 4.4 mm when visual acuity (VA) was better than 20/200, and 5.2 mm when VA was 20/200 or worse (P = .076). Eyes receiving additional surgery grew more than eyes not receiving additional surgery (P = .052). Patients with glaucoma showed significantly more eye growth (7.3 mm) than those without glaucoma (4.7 mm) and glaucoma suspects (5.1 mm) (P < .05).
Conclusions:
Eyes with glaucoma or poor VA often grew longer than the fellow eye. Overall, treated eyes grew similarly in the IOL and CL groups and also kept pace with the growth of the fellow eyes.
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