Prevalence of strabismus 10 years after infantile cataract surgery
Reviewed by Lauren Hepworth

The authors present a secondary analysis of the longitudinal data on ocular alignment from the Infant Aphakia Treatment Study (IATS). The details of the trial are published elsewhere. This paper focuses on the ocular alignment assessment at age 10.5 years, performed at both near and distance. A total of 109 children completed the assessment at this timepoint. Almost 90% of this cohort had strabismus at either near or distance. Half the cohort had undergone strabismus surgery before age 10 years. The prevalence of strabismus and occurrence of strabismus surgery were equal regardless of treatment regime, contact lens care or primary intraocular lens. Exotropia was the most prevalent type of strabismus (45%). Regardless of the treatment chosen to manage aphakia, strabismus was common in these children. Children with better visual acuity were more likely to be orthotropic or microtropic. The mechanism behind this finding is not fully understood, in that does better alignment post-cataract surgery results in more successful amblyopia treatment or better acuity protects against development of strabismus. The authors recommend caution be taken when managing esotropia early with strabismus surgery, based on the findings of this 10-year follow-up.

Long-term strabismus outcomes after unilateral infantile cataract surgery in the Infant Aphakia Treatment Study.
Bothun ED, Shainberg MJ, Christiansen SP, et al.
JOURNAL OF THE AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2022;26(4):174.