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Comparative Study
. 2017 May;124(5):730-733.
doi: 10.1016/j.ophtha.2017.01.010. Epub 2017 Feb 10.

Globe Axial Length Growth at Age 5 Years in the Infant Aphakia Treatment Study

M Edward Wilson  1 , Rupal H Trivedi  2 , David R Weakley Jr  3 , George A Cotsonis  4 , Scott R Lambert  5 ; Infant Aphakia Treatment Study Group
Affiliations
Comparative Study

Globe Axial Length Growth at Age 5 Years in the Infant Aphakia Treatment Study

M Edward Wilson et al. Ophthalmology. 2017 May.

Abstract

Purpose: To report the longitudinal change in axial length (AL) from the time of unilateral cataract surgery at age 1 to 7 months to age 5 years, and to compare AL growth of operated eyes with that of fellow unoperated eyes.

Design: Comparative case series.

Participants: Infants enrolled in the Infant Aphakia Treatment Study (IATS).

Methods: The AL at baseline and age 5 years and change in AL were analyzed relative to treated versus fellow eye, visual outcome, and treatment modality (contact lens [CL] vs. intraocular lens [IOL]). Eyes with glaucoma or glaucoma suspect were excluded from primary analysis but reported separately.

Main outcome measures: The AL growth from preoperative to age 5 years.

Results: Seventy patients were eligible; however, AL data for both eyes were available for 64 patients at baseline and 69 patients at age 5 years. The AL was significantly different between treated and fellow eyes preoperatively (18.1 vs. 18.7 mm, P < 0.0001) and at the final follow-up (21.4 vs. 22.1 mm, P = 0.0004). The difference in AL growth between treated and fellow eyes was not significant (3.3 vs. 3.5 mm, P = 0.31). The change in AL in eyes was similar with both treatments (CL 3.2 mm and IOL 3.4 mm, P = 0.53) and did not correlate with visual outcomes (P = 0.85). Eyes receiving additional surgery to clear the visual axis opacification grew significantly more compared with eyes not receiving surgery to clear the visual axis (3.8 vs. 2.7 mm, P = 0.013). Patients with glaucoma showed significantly more eye growth (5.7 mm) than those without glaucoma (3.3 mm) and glaucoma suspects (4.3 mm).

Conclusions: Eyes treated for monocular cataract in infancy have axial growth similar to that of fellow eyes, despite having a shorter AL at the time of surgery. The change in AL in eyes was similar with both treatments (CL and IOL), did not correlate with visual outcomes, and was higher in eyes receiving additional surgery to clear the visual axis or eyes diagnosed with glaucoma.

Trial registration: ClinicalTrials.gov NCT00212134.

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Conflict of interest statement

Proprietary interests: none

References

    1. Lambert SR. Changes in Ocular Growth after Pediatric Cataract Surgery. Dev Ophthalmol. 2016;57:29–39. - PubMed
    1. Lambert SR, Lynn MJ, DuBois LG, Cotsonis GA, Hartmann EE, Wilson ME, Infant Aphakia Treatment Study G Axial elongation following cataract surgery during the first year of life in the infant Aphakia Treatment Study. Invest Ophthalmol Vis Sci. 2012;53(12):7539–7545. - PMC - PubMed
    1. Infant Aphakia Treatment Study G. Lambert SR, Buckley EG, Drews-Botsch C, DuBois L, Hartmann E, Lynn MJ, Plager DA, Wilson ME. The infant aphakia treatment study: design and clinical measures at enrollment. Arch Ophthalmol. 2010;128(1):21–27. - PMC - PubMed
    1. Kugelberg U, Zetterstrom C, Syren-Nordqvist S. Ocular axial length in children with unilateral congenital cataract. Acta Ophthalmol Scand. 1996;74(3):220–223. - PubMed
    1. Trivedi RH, Wilson ME. Biometry data from caucasian and african-american cataractous pediatric eyes. Invest Ophthalmol Vis Sci. 2007;48(10):4671–4678. - PubMed

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