Editor,
We appreciate the interest of Takkar and colleagues in our recent publication, “Myopic shift 5 years after IOL implantation in the Infant Aphakia Treatment Study.”1 We previously published the changes in axial length in the treated and fellow eyes for both the contact lens and intraocular lens (IOL) treated groups.2 The difference in axial length growth between treated and fellow eyes was not significant and the change in axial length between treated eyes in the contract lens and IOL groups was similar at age 5 years (CL 3.2 mm, IOL 3.4 mm). While animal studies have reported that the relative peripheral refraction affects the rate of axial growth, studies in human have failed to find this association.3–5 To the contrary, two recent studies found that the myopic shift increased when myopic children switched from spectacles to contact lenses.6,7 We have not been able to identify preoperative factors that are helpful in predicting the magnitude of the myopic shift in infantile eyes following unilateral cataract surgery and IOL implantation. This is another reason to defer implanting an IOL in an infant’s eye in addition to the higher adverse event rate associated with IOL implantation compared to aphakia.8 By deferring IOL implantation until the axial length of these eyes has stabilized, the risk of high anisometropia and an IOL exchange can potentially be adverted.9
Acknowledgments
Supported by National Institutes of Health Grants U10 EY13272 and U10 EY013287 and in part by NIH Departmental Core Grant EY006360 and Research to Prevent Blindness, Inc, New York, New York
Footnotes
Proprietary interests: none
Trial Registration: clinicaltrials.gov Identifier NCT00212134
References
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