Migration to aphakia and contact lens treatment is the trend in the management of unilateral congenital cataract in Britain and Ireland

Ir J Med Sci. 2019 Aug;188(3):1021-1024. doi: 10.1007/s11845-018-1908-9. Epub 2018 Sep 29.

Abstract

Background: The Infant Aphakia Treatment Study (IATS) compared the treatment of unilateral cataract in infants aged 1-6 months with primary intraocular lens (IOL) implantation vs aphakia with contact lens (CL) correction.

Aims: This study aims to assess the current trends in the treatment of unilateral congenital cataract in infants less than 6 months at surgery in the UK and Ireland.

Methods: An anonymous survey was emailed to the 200 members of the BIPOSA mailing list with 14 questions to assess treatment choice (primary intraocular lens (IOL) vs aphakia with contact lens (CL)), reasons for this choice, and assessment of local CL services.

Results: There were 56 respondents, 39 of whom completed the entire survey. Aphakia with CL was the treatment choice for 74.4% of respondents. A quarter (25.6%) of respondents said they were performing primary IOL implantation prior to the publication of the Infant Aphakia Treatment Study (IATS), but now choose aphakia with CL. Amongst the 20.5% (n = 8) of respondents who chose primary IOL implantation, 5 attributed their choice to "inadequate CL service". The majority (84.6%) of respondents rated their infant CL service as either "good" or "very good".

Conclusion: Aphakia with CL rehabilitation was the most common approach to the treatment of unilateral congenital cataract in infants less than 6 months in this study. The results of the IATS appear to have influenced a change in practice from primary IOL implantation to aphakia and CL visual rehabilitation in approximately one quarter of those surveyed.

Keywords: Congenital cataract; Ophthalmology.

MeSH terms

  • Aphakia, Postcataract / therapy*
  • Cataract / congenital*
  • Cataract / therapy*
  • Contact Lenses*
  • Female
  • Humans
  • Infant
  • Ireland
  • Lens Implantation, Intraocular / methods*
  • Male
  • United Kingdom