American journal of ophthalmology | 2019
Spectacle Adherence Among Four-Year-Old Children in the Infant Aphakia Treatment Study.
Abstract
PURPOSE\nTo evaluate spectacle adherence with impact-resistant lenses among 4-year-old children after unilateral cataract surgery in the Infant Aphakia Treatment Study.\n\n\nDESIGN\nRetrospective cohort analysis of randomized clinical trial data.\n\n\nMETHODS\nSetting: Multicenter.\n\n\nPATIENTS\nOne hundred and fourteen children randomized to contact lens correction or intraocular lens implantation following unilateral cataract surgery during infancy.\n\n\nINTERVENTION\nOne-week diaries completed annually and retrospective telephone interviews conducted every 3\xa0months to age 5 years to assess spectacle adherence with impact-resistant lenses. Visual acuity was assessed by a traveling examiner at age 4.5 years.\n\n\nMAIN OUTCOME MEASURES\nSpectacle adherence between ages 4 and 5 years.\n\n\nRESULTS\nChildren with 20/40 or better vision in their treated eye were more likely to wear spectacles ≥80% of their waking hours than children with vision worse than 20/40 (66% vs 42%, P\xa0= .034). Reported adherence to spectacle wear correlated with reported patching (r\xa0=\xa00.30, P\xa0=\xa0.002). Spectacle adherence did not correlate with sex, type of healthcare insurance, or the refractive error in the treated or fellow eye. Seven patients with reduced vision in their treated eye reported <10% spectacle adherence.\n\n\nCONCLUSIONS\nThese results confirm that it is possible to achieve high levels of spectacle adherence among 4-year-old children after unilateral cataract surgery during\xa0infancy. However, children with vision worse than 20/40 in their worse eye, who needed eye protection the most, had the worst adherence.