Fixation control and eye alignment in children treated for dense congenital or developmental cataracts
Journal of AAPOS, 05/02/2012
Birch EE et al. – Laterality and age at onset were significant nonmodifiable risk factors for adverse ocular motor outcomes. Duration of deprivation was a significant modifiable risk factor for adverse ocular motor outcomes. The current study demonstrated that reduced risk for nystagmus and strabismus was associated with deprivation ≤6 weeks.Methods
- Children who had undergone extraction of dense cataracts by the age of 5 years were enrolled postoperatively.
- Ocular alignment was assessed regularly throughout follow-up.
- Fixation stability and associated ocular oscillations were determined from eye movement recordings at ≥5 years old.
- Multivariate logistic regression was used to evaluate whether laterality (unilateral vs bilateral), age at onset, and/or duration of visual deprivation were associated with adverse ocular motor outcomes and to determine multivariate odds ratios (ORs).
- A total of 41 children were included.
- Of these, 27 (66%) developed strabismus; 29 (71%) developed nystagmus.
- Congenital onset was associated with significant risk for strabismus (OR, 5.3; 95% CI, 1.1-34.1); infantile onset was associated with significant risk for nystagmus (OR, 13.6; 95% CI, 1.6-302).
- Duration >6 weeks was associated with significant risk for both strabismus (OR, 9.1; 95% CI, 1.9-54.2) and nystagmus (OR, 46.2; 95% CI, 6.0-1005).
- Congenital onset was associated with significant risk for interocular asymmetry in severity of nystagmus (OR, 25.0; 95% CI, 2.6-649), as was unilateral cataract (OR, 58.9; 95% CI, 5.1-2318).