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Joost Felius, Claudio Busettini, Scott R Lambert, Michael J Lynn, E Eugenie Hartmann, Infant Aphakia Treatment Study Group; 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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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.
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).
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).
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.
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