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- One-Year Results Reported for the Infant Aphakia Treatment Study
According to conclusions drawn by investigators in the IATS (Infant Aphakia Treatment Study), modern surgical techniques do not eliminate the early development of glaucoma following congenital cataract surgery with or without an IOL.
Reporting in the Archives of Ophthalmology, the investigators wrote, “Younger patients with or without persistent fetal vasculature seem more likely to develop a glaucoma-related adverse event in the first year of follow-up.” Allen D. Beck, MD, the William and Clara Redmond Professor of Ophthalmology and director, Section of Glaucoma, Emory Eye Center, and colleagues called on eye care practioners to be vigilant for the early development of glaucoma following congenital cataract surgery, “especially when surgery is performed during early infancy or for a child with persistent fetal vasculature.”
BACKGROUND OF IATS
The IATS investigators sought to report the incidence of and suspicion for glaucoma and to evaluate risk factors for the development of glaucoma-related adverse events in patients during the first year of follow-up. According to the report, a total of 114 infants between 1 and 6 months of age with a unilateral congenital cataract were assigned to undergo cataract surgery with or without an IOL. The study’s investigators created and used a standardized definition of glaucoma and glaucoma suspect.
Of the 114-patient cohort, 10 (9%) developed glaucoma, and four (4%) were suspicious for glaucoma, totaling 14 patients (12%) with a glaucoma-related adverse event in the treated eye through the first year of follow-up. Of the 57 patients who underwent lensectomy with anterior vitrectomy, five (9%) developed a glaucoma-related adverse event. Of the 57 patients who had a lens implanted, nine (16%) developed a glaucoma-related adverse event. The odds of developing a glaucoma-related adverse event were 3.1 times higher for a child with persistent fetal vasculature and 1.6 times higher for each month of age younger at the time of cataract surgery.
“Five-year follow-up data for the IATS will likely reveal more glaucoma-related adverse events,” the authors concluded. For more information on the IATS, visit the US National Institutes of Health Clinical Trials registry at clinicaltrials.gov/show/NCT00212134.