Early Patching Behaviors That Improve the Chances of Good Visual Acuity in Children Treated for Unilateral Congenital Cataract

Abstract

Purpose

Achieving near normal vision after unilateral congenital cataract (UCC) surgery is possible but requires early surgery, optical correction, and consistent patching. Patching is often challenging for children and their caregivers. The goal of these analyses is to examine the association between reported consistency in patching during the first year after surgery and visual acuity (VA).

Design

Data from the Infant Aphakia Treatment Study (IATS) are used in a cohort design.

Participants

A total of 101 children whose caregivers completed a prospective, 7-day patching diary 2 months after surgery or at 13 months of age.

Methods

Consistent patching was defined as patching every day and either an average patch start time before 9:00 am or the interquartile range of the first time a patch was applied of 60 minutes or less.

Main Outcome Measures

Recognition VA was assessed at ages 54+ 1 months and 10.5 years. Near normal VA was defined as VA of 20/40 or better.

Results

Diary data were available for 101 children. Overall, 55% of children whose caregivers reported consistent patching at age 13 months had near normal vision at age 54 + 1 months and 45% had near normal vision at age 10.5 years compared with 14% and 19%, respectively, when caregivers reported less consistent patching (adjusted relative risk at 54 months of age 3.55, 95% confidence interval [CI], 1.61–7.80; adjusted relative risk at 10.5 years of age 2.31, 95% CI, 1.12–4.78).

Conclusions

Consistent patching in the first year after surgery for UCC is associated with better VA. These findings can be used to provide evidence-based guidance to caregivers to help improve VA outcomes for their children.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.