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The Infant Aphakia Treatment Study randomized infants aged 1 to 7 months with unilateral congenital cataract to primary intraocular lens implantation or contact-lens correction after cataract extraction. At 4.5 years, median visual acuity was not significantly different between the treatment groups. However, children who received primary IOLs had more adverse events and substantially more additional intraocular surgeries. The study therefore provides a strong evidence base against assuming that immediate IOL implantation is automatically better simply because it eliminates the need for a contact lens. The decision in very young infants should account for ocular anatomy, family ability to manage contact lenses, amblyopia treatment and the risks of additional surgery. For HCPs, the findings are highly relevant to paediatric cataract counselling: the best optical correction is not necessarily the most surgically aggressive option. AIOC's paediatric cataract content can use this evidence to frame decision-making around age, safety and long-term visual development.
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The Infant Aphakia Treatment Study randomized infants aged 1 to 7 months with unilateral congenital cataract to primary intraocular lens implantation or contact-lens correction after cataract extraction. At 4.5 years, median visual acuity was not significantly different between the treatment groups. However, children who received primary IOLs had more adverse events and substantially more additional intraocular surgeries. The study therefore provides a strong evidence base against assuming that immediate IOL implantation is automatically better simply because it eliminates the need for a contact lens. The decision in very young infants should account for ocular anatomy, family ability to manage contact lenses, amblyopia treatment and the risks of additional surgery. For HCPs, the findings are highly relevant to paediatric cataract counselling: the best optical correction is not necessarily the most surgically aggressive option. AIOC's paediatric cataract content can use this evidence to frame decision-making around age, safety and long-term visual development.
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