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Surgical lens might not be best treatment for congenital cataracts

Thu, 05/13/2010 - 7:43am
Baylor College of Medicine
HOUSTON -- (May 10, 2010) -- Surgically implanting lenses in the eyes of infants born with cataracts might increase the rate of surgical complications, said a Baylor College of Medicine eye specialist who took part in a study comparing the use of a contact lens with surgically placing a plastic lens in the baby's eye after removing the cataract. She advised caution in considering the placement of an intraocular lens in infants.

While placement of an intraocular lens eliminates the need to insert and remove contact lenses in infants, it might not be a superior treatment, a consortium of researchers including BCM said in a report that appears online early in the Archives of Ophthalmology.

Evaluating new treatments

"The goal of this study was to evaluate the visual outcomes and effects of the newer treatment (placement of intraocular lenses) versus the use of a contact lens after surgery," said Dr. Kimberly Yen, an assistant professor of ophthalmology at BCM and principal investigator on the BCM study site.

A total of 114 infants were part of the study that included 11 institutions, including BCM. All the babies had a cataract in one eye.

Infants who are born with visually significant cataracts undergo surgery to remove the cloudy natural lens of the eye. In this study, babies received either a contact lens after surgery or a surgically implanted plastic lens to replace the one that was removed. The surgery, which was conducted at Texas Children's Hospital, took place between 1 month and 7 months of age. The vision of the infants was evaluated at 1 year of age.

"Using contact lenses in infants is safe, but can be very frustrating for the parent or guardian," said Yen. "They are difficult to insert and remove. There is a high risk of lens loss and compliance with the treatment can be poor, which lead to poor visual outcomes."

Nothing shows implantable lenses better

The researchers found little difference in the visual outcome at 1 year of age between the two methods. However, those patients who had the surgically implanted lens had a higher rate of complications during surgery and were also five times more likely to undergo additional intraocular operations.

"The implantable lenses are standard for adults treated for cataracts," said Yen. "But for infants, the technology has only recently been used."

"There is no compelling result from this study that shows the implantable lenses are better than the use of contact lenses," said Yen.

She said that researchers plan to check the visions of the infants who took part in this study when they reach age 4.

About one in 15,000 children are born with cataracts.

Often, cataracts occur because the children inherited the condition or have another disease that is associated with the vision problem, said Yen, also a pediatric ophthalmologist at Texas Children's.

Funding for this study came from the National Institutes of Health and the advocacy group Research to Prevent Blindness.

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