Peekabo! Eye See You! The Infant Aphakic Treatment Study (IATS) sought to compare visual outcomes in infants (aged 1-6 months) with a unilateral congenital cataract following cataract extraction surgery and either intraocular lens (IOL) implantation or left aphakic with contact lens usage. Patients then received the same patching therapy and were followed up for up to 5 years.
The IATS showed that with regards to neutral visual acuity outcomes and increased postoperative complications and intraoperative additional procedures, it is better to leave babies who are operated on in the first 6 months of life aphakic and use a contact lens, with the plan to implant an IOL a few years later. A variety of reasons may account for these findings, including a less-traumatic surgery with fewer reoperations needed later in life and a better fitted IOL. Still, for patients whom placing contact lenses may be unreasonable, it is worthy to consider lOL placement weighed against the potential risks to avoid amblyopia.
- The average visual acuity is not different between the 2 treatment groups.
- The proportion of adverse events was higher in the IOL group (81%) than contact lens (56%) group.
- The proportion of additional intraoperative procedures was higher in the IOL group (72%) than the contact lens (12%) group.
- The percentage of participants included in the adherence analyses did not differ by treatment group.