Aphakia causes, optics, clinical features and treatment. Amblyopia and nystagmus occur when the brain is denied an image and pathways, which allow the brain to process images, are not formed. Pdf the infant aphakia treatment study contact lens experience. This method has been used in other similar studies and would allow. Purpose to report strabismus surgery frequency and outcomes after monocular infantile cataract surgery with or without iol implantation. Lambert has been chairman of the infant aphakia treatment study since 2004. Listing a study does not mean it has been evaluated by the u. The infant aphakia treatment study is a randomized, multicenter n 12, clinical trial comparing treatment of aphakia with a primary iol or contact lens in 114 infants with a unilateral congenital cataract. Many studies confirm the reliability and validity of the total stress score abidin, 1995. Comparison of contact lens and intraocular lens correction.
Lambert d a department of epidemiology, rollins school of public health, emory university, united states b department of biostatistics, rollins school of public health, emory university, united states. The entire patient pathway is covered, from preoperative assessment through application of the various surgical techniques to postoperative care and management of complications. Handbook of clinical trials in ophthalmology ebook pdf. The infant aphakia treatment study iats is a multicenter, randomized, controlled clinical trial sponsored by the national eye institute. The infant aphakia treatment study iats is a multicenter, randomized, controlled clinical trial comparing iol and contact lens treatments after cataract surgery performed in children with a unilateral congenital cataract at 1 to 6 months of age. Fiftyseven of the 114 infants in the iats were randomized to contact lens wear. The infant aphakia treatment study contact lens experience. Assessment of adherence to visual correction and occlusion therapy in the infant aphakia treatment study carolyn drewsbotsch a, george cotsonis b, marianne celano c, scott r.
Motor skills of children with unilateral visual impairment. Study protocol and statistical analysis plan pdf april 29, 2015. Infant aphakia contact lens wear and cataract surgery. Surgery was performed by a studycertified, fellowshiptrained pediatric ophthalmologist using a standardized surgical technique approved by iats committee 5 x 5 the infant aphakia treatment study group. However, the infant aphakia treatment study was designed to provide empirical evidence of whether optical treatment with an iol or a contact lens after unilateral cataract surgery during. Cataract surgery in infant eyes with microphthalmos pdf. Glaucomarelated adverse events in the infant aphakia. We have been operating on pediatric cases for over 10 years and. With publication of its 5year results, the infant aphakia treatment study iats helped illuminate the way forward for these children. Lessons learned about cataract surgery from the infant aphakia. To compare the use of contact lenses and intraocular lenses iols for the optical correction of unilateral aphakia during infancy. To share knowledge gained from the infant aphakia treatment study on the management.
The aim of iats is to compare the visual outcomes and complications of the correction of aphakia using a contact lens to those when an iol is placed primarily after monocular cataract surgery in infants aged. An examination under anesthesia, including keratometry, was performed. The infant aphakia treatment study iats did not find a significant difference in visual acuity for infants with a unilateral congenital cataract iats iats the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Risks and outcomes associated with primary intraocular. Pdf parenting stress in the infant aphakia treatment study. Primary intraocular lens iol implantation after congenital cataract surgery in infants has always been controversial. Pdf the infant aphakia treatment study design and clinical. Abstract this prospective study assessed visual results and subjective rehabilitation after cataract surgery in eyes with a preoperative acuity of 0.
Axial elongation following cataract surgery during the first year of life in the infant aphakia treatment study. The study concluded that the visual outcomes were similar in both treatment groups, but there were more intraoperative and. A concise guide to diagnosis and management pdf author ian christopher lloyd isbn 3319278460 file size 10. Methods the infant aphakia treatment study iats is a randomized, multicenter clinical trial comparing treatment of aphakia with a primary iol or contact lens in 114 infants with a unilateral congenital cataract. Intraocular lens implantation in children with cataract. Cataract surgery in infant eyes with microphthalmos in their study,1 vasavada et al. Why is there an infant aphakia treatment study iats. Download pdf although contact lenses have been used for decades to correct vision in children after cataract surgery, prospective data on adherence to lens wear are limited. Moreover, the infant aphakia treatment study iats found that if only one half of the patients in the contact lens aphakic group eventually undergo secondary intraocular lens implantation, the number of additional intraocular surgeries in the 2 groups will be approximately equal.
Psychosocial impact of amblyopia and its treatment. Evaluation of eyerelated parameters and adverse events of. Emory eye magazine, summer 2010 download a pdf copy. Infant aphakia treatment study hhs public access am j. The infant aphakia treatment study iats was a randomized, multicenter clinical trial that compared visual outcomes at age 4. The perception of pediatric ophthalmologists regarding the implantation of iols in children has changed radically during the past two decades. Migration to aphakia and contact lens treatment is the. To describe our experience treating a cohort of unilateral aphakic infants with contact lenses in the infant aphakia treatment study iats. The infant aphakia treatment study iats is a multicenter, randomized, controlled clinical.
This can occur in one or both eyes, but there are treatments available to improve a childs eyesight. Treatment for infant aphakia is an issue that people are asking about in every country we visit, because most countries dont have the resources to do this kind of trial. Cataract surgery in eyes with early cataracts pdf free. The most critical time for improve is during the first year of a childs life.
With the advances in the surgical instruments and techniques, commercial availability of hydrophobic iols, and improvements in modes. This book aims to assist ophthalmologists in providing the best possible care for children with congenital. Parenting stress in the infant aphakia treatment study. However, the infant aphakia treatment study was designed to provide empirical evidence of whether optical treatment with an iol or a contact lens after unilateral cataract surgery during infancy is associated with a better visual outcome. Assessment of adherence to visual correction and occlusion. Congenital cataract advances in ophthalmology and optometry. The infant aphakia treatment study iats is a randomized, controlled multicenter clinical trial with the following objectives. Motor skills of children with unilateral visual impairment in the infant aphakia treatment study marianne celano, phd, abpp1, e. The infant aphakia treatment study iats is a multicenter randomized clinical trial.
Factors associated with stereopsis and a good visual. The infant aphakia treatment study iats is a multicenter, randomized, controlled. Infant aphakia treatment study iats full text view. Partnering with the pediatric ophthalmology service.
The infant aphakia treatment study iats is a multicenter, randomized, controlled clinical trial. Congenital cataract a concise guide to diagnosis and. Secondary outcome analysis in a prospective, randomized clinical trial. The optimal optical treatment of aphakia in infants is unknown. Contact lens and surgery can be used to correct many visions problems in. The refractive management of infantile aphakia and. There were 114 children enrolled in the study with 57 randomized to each treatment group. Parenting stress in the infant aphakia treatment study journal of. The infant aphakia treatment study iats is a clinical study designed to determine which treatment for aphakia is better for infants between the ages of 4 weeks to 7 months who were born with a cataract in one eye. It is for this reason that the infant aphakia treatment study iats study. To evaluate spectacle adherence with impactresistant lenses among 4yearold children after unilateral cataract surgery in the infant aphakia treatment study. Aphakia literally means absence of crystalline lens from an ophthalmological point of view, aphakia is the absence of the lens in the pupillary area causes of aphakia congenital aphakia surgical aphakia removal of lens as in cataract extraction aphakia due to absorption of lens sometimes seen in children after trauma traumatic extrusion of. The infant aphakia treatment study is a randomized clinical trial in which the investigators compared intraocular lens iol versus contact lens correction in 114 infants, aged 28 days to infant aphakia treatment study iats helped illuminate the way forward for these children.
In years 25 following surgery, the patients were examined by an infant aphakia treatment study certified investigator every 3 months until 4. Infant aphakia treatment study iats iats the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. The infant aphakia treatment study is a randomized clinical trial in which the investigators compared intraocular lens iol versus contact lens correction in 114 infants, aged 28 days to jun 17, 2016. Refractive shift in pseudophakic eyes during the second decade of life.
Design retrospective cohort analysis of randomized clinical trial data. Spectacle adherence among fouryearold children in the. In a secondary analysis of the infant aphakia treatment study, cromelin et al. The following studies are to be performed during the examinationunder anesthesia. A concise guide to diagnosis and management join ammedicine group preface this book aims to assist ophthalmologists in providing the best possible care for children with congenital cataracts. Conclusions this analysis concurs with previous studies that early surgery is important for good visual outcomes in patients with unilateral infantile cataracts. The infant aphakia treatment study iats is a multicenter, randomized. To assess motor functioning in children aged 4 years 6 months enrolled in the infant aphakia treatment study, and to determine contributions of visual acuity and stereopsis to measured motor skills. He is chairman of the pediatric ophthalmic technology assessment committee otac, american academy of ophthalmology, and an executive committee member of the pediatric eye diseases investigator group pedig. The infant aphakia treatment study iats is a multicenter randomized clinical trial comparing intraocular lens and contact lens correction for monocular aphakia. The following studies are to be performed during the examinationunderanesthesia. T1 glaucomarelated adverse events in the infant aphakia treatment study.