Visual Axis Opacity after Intraocular Lens Implantation in Children in the First 2 Years of Life
| Autor: | Taras Gout, Ameenat Solebo, Jugnoo Rahi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Longitudinal study genetic structures medicine.medical_treatment Population Intraocular lens Aphakia 03 medical and health sciences 0302 clinical medicine Ophthalmology medicine education Prospective cohort study 030304 developmental biology 0303 health sciences education.field_of_study business.industry Odds ratio medicine.disease eye diseases Confidence interval 030221 ophthalmology & optometry sense organs business Cohort study |
| Zdroj: | Ophthalmology. 127:1220-1226 |
| ISSN: | 0161-6420 |
| DOI: | 10.1016/j.ophtha.2020.02.038 |
| Popis: | Purpose Appropriate correction of aphakia is key to good outcomes. There may be clinical settings where and populations in whom accessing or managing aphakic contact lenses is challenging. Strategies to target the increased risk of visual axis opacity (VAO) after primary intraocular lens (IOL) implantation in infancy are necessary. We describe the predictors of VAO after primary IOL implantation for unilateral or bilateral congenital or infantile cataract in children younger than 2 years of age. Design Population-based (United Kingdom and Ireland), prospective, inception cohort study undertaken through a national clinical network. Participants A total of 105 children (57 with bilateral cataract, 48 with unilateral cataract, total 162 eyes) undergoing primary IOL implantation in the first 2 years of life between January 2009 and December 2010. Methods Observational longitudinal study with multilevel, multivariable modeling to investigate associations between outcome of interest and child- and treatment-specific factors, including age, axial length, socioeconomic status, IOL model, and postoperative steroid use. Main Outcome Measures Postoperative proliferative or inflammatory visual axis opacity (VAO) requiring surgical correction. Results Visual axis opacity occurred in 67 eyes (45%), typically within the first postoperative year. Use of a 3-piece IOL model (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.09–0.99, P = 0.03) and increasing age at surgery (OR, 0.97, 95% CI, 0.95–0.99, P = 0.02) were each independently protective against the development of proliferative VAO. Inflammatory VAO was independently associated with socioeconomic deprivation (OR, 5.39; 95% CI, 1.46–19.89; P = 0.01). Conclusions Visual axis opacification is common after IOL implantation in early childhood. The findings of this prospective cohort study suggest that the use of 3-piece IOL models may reduce the risk of pseudophakic VAO in children younger than 2 years of age. |
| Databáze: | OpenAIRE |
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