April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
The Infant Aphakia Treatment Study (IATS): Fixational Instabilities Following Extraction of Unilateral Infantile Cataract
Author Affiliations & Notes
  • Joost Felius
    Retina Foundation of the Southwest, Dallas, TX
    Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX
  • Claudio Busettini
    Vision Sciences, University of Alabama at Birmingham, Birmingham, AL
  • Scott R Lambert
    Ophthalmology, Emory University, Atlanta, AL
  • Michael J Lynn
    Biostatistics and Bioinformatics, Emory University, Atlanta, AL
  • E Eugenie Hartmann
    Vision Sciences, University of Alabama at Birmingham, Birmingham, AL
  • Footnotes
    Commercial Relationships Joost Felius, None; Claudio Busettini, None; Scott Lambert, None; Michael Lynn, None; E Eugenie Hartmann, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 2663. doi:
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      Joost Felius, Claudio Busettini, Scott R Lambert, Michael J Lynn, E Eugenie Hartmann, ; The Infant Aphakia Treatment Study (IATS): Fixational Instabilities Following Extraction of Unilateral Infantile Cataract. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2663.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To study eye movement abnormalities in a large group of children after the removal of unilateral infantile cataract, and to compare fixational instabilities between treatment groups with or without intraocular lens (IOL) implantation.

Methods: The Infant Aphakia Treatment Study (IATS) is a randomized, multicenter clinical trial comparing IOL to contact lens (CL) treatment in 114 infants with a unilateral infantile cataract who underwent cataract surgery at 1 to 6 months of age. During a study visit at age 4.5 years, eye movements were recorded using a high-speed video camera while the child fixated a target at 3 m. Recordings were filtered and digitized, then inspected by a masked examiner for the presence of fixational instabilities (nystagmus and saccadic oscillations).

Results: Not all scheduling was successful and not all recordings were scorable, resulting in data for 83 children. Overall, fixational instabilities were observed in 50 children (60%), with no differences between treatment groups (26 in the IOL group, 24 in the CL group; Fisher’s exact test, P=0.82). Nystagmus was seen in 38% and saccadic oscillations in 31%, with no differences between treatment groups (P=0.49 and 0.33, respectively).

Conclusions: Nystagmus and saccadic oscillations are well-known consequences of infantile cataracts, presumably the result of visual deprivation during the critical period of visual development. After early cataract extraction, successful optical correction should reduce further form deprivation and minimize the incidence of these fixational instabilities. In this study, no differences in the presence of fixational instabilities were found between the two initial strategies (CL or IOL) for optical correction after cataract removal.

Keywords: 522 eye movements • 445 cataract • 757 visual development: infancy and childhood  
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