The Infant Aphakia Treatment Study Contact Lens Experience to Age 5 Years

Purpose: To describe our experience treating a cohort of unilateral aphakic infants with contact lenses in the Infant Aphakia Treatment Study (IATS). Materials and methods: Fifty-seven of the 114 infants in the IATS were randomized to contact lens wear; all were followed until age 5 years, although a few had lapses in care. An examination under anesthesia, including keratometry, was performed at the time of enrollment and at approximately 1 year of age; keratometry was performed again at 5 years of age. A traveling examiner assessed visual acuity at approximately 1 year of age and again at 4.5 years of age. Results: Twenty-four treated eyes (46%) wore silicone elastomer (SE) contact lenses, 11 eyes (19%) rigid gas permeable (GP) contact lenses and 17 eyes (29%) wore both lens types at various points of time. Median logMAR visual acuity was +0.70 (interquartile range (IQR), +0.30 to 1.20) in the SE group and 2.03 (IQR, +0.20 to 2.28) in the GP group at age 4.5 years. The mean (+/- SD) keratometric power of the treated eyes was 46.362.8 diopter (D) at baseline, 44.6 +/- 2.3 D at 1 year of age, and 44.361.7 D at 5 years of age. Keratometric astigmatism of treated eyes was 1.98 +/- 1.37 D at baseline, 1.62 +/- 0.98 D at 1 year of age, and 2.00 +/- 1.00 D at 5 years of age. Thirteen contact lens-related adverse events occurred among 7 patients after age 1 year. Conclusions: A cohort of infants with unilateral aphakia successfully wore contact lenses with relatively few adverse events.