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Early Patching Behaviors That Improve the Chances of Good Visual Acuity in Children Treated for Unilateral Congenital
Carolyn Drews-Botsch1, E Eugenie Hartmann2, Marianne Celano3
1Department of Global and Community Health, George Mason University, Fairfax, Virginia.
Insights
Consistent patching after unilateral congenital cataract surgery significantly improves visual acuity (VA) in children. Adherence to patching regimens in the first year is crucial for achieving near normal vision outcomes.
Area of Science:
- Ophthalmology
- Pediatric medicine
- Vision science
Background:
- Unilateral congenital cataract (UCC) surgery requires early intervention, optical correction, and consistent patching for optimal visual outcomes.
- Patching therapy presents significant challenges for children and their caregivers.
Purpose of the Study:
- To investigate the association between the consistency of patching during the first year post-surgery and visual acuity (VA) in children treated for UCC.
- To provide evidence-based guidance for caregivers to enhance VA outcomes.
Main Methods:
- A cohort study utilizing data from the Infant Aphakia Treatment Study (IATS).
- Included 101 children whose caregivers maintained a prospective, 7-day patching diary.
- Consistent patching was defined by daily adherence and specific timing parameters (early start or narrow time range).
Main Results:
- Children with consistent patching at 13 months showed significantly higher rates of near normal vision (55% at 54 months, 45% at 10.5 years) compared to those with less consistent patching (14% and 19%, respectively).
- Adjusted relative risks indicated a 3.55-fold increase in near normal vision at 54 months and a 2.31-fold increase at 10.5 years for consistently patched children.
Conclusions:
- Consistent patching in the initial year after UCC surgery is strongly associated with improved visual acuity.
- These findings support the importance of adherence to patching protocols for better long-term visual outcomes in children.
Purpose:
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).
Design:
Data from the Infant Aphakia Treatment Study (IATS) are used in a cohort design.
Participants:
A total of 101 children whose caregivers completed a prospective, 7-day patching diary 2 months after surgery or at 13 months of age.
Methods:
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.
Main Outcome Measures:
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.
Results:
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).
Conclusions:
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.
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