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• W2013116975 abstract "IntroductionWhen fitting infant aphakic eyes with a contact lens (CL) immediately after cataract surgery, it may not always be possible to obtain an accurate refraction. For such cases there is a tendency is to insert a +32 D CL. We sought to provide guidelines for the selection of an initial CL power if retinoscopy over a diagnostic lens is not possible.MethodsPatients with a unilateral cataract and randomized to CL treatment in the Infant Aphakia Treatment Study (IATS) were analyzed. An eye was included if there was a valid preoperative axial length (AL) measurement using immersion and a one-month postoperative refraction. Target CL power was determined using refraction (adjusting for vertex distance of 12 mm) over known CL power one-month postoperatively. We compared it with four techniques: (1) physician’s estimated CL power (defined as the prescribed CL power minus 2D overcorrection based on IATS protocol); (2) regression1, CL power = 84.4-3.2 × AL; (3) SRK/T IOL power1 calculated using a modified A-constant (112.176); (4) 32 D CL.ResultsThere were 36 of 57 eyes that met the inclusion criteria. Age at cataract surgery was 2.3 ± 1.7months. Preoperative AL was 17.9 ± 1.6 mm. Follow-up refraction was performed at 31 ± 3 days. Target CL power based on the one-month refraction was 26.0 ± 4.4 D. Mean prediction error was 0.4, −1.0, −2.0, and 6.2 D and mean absolute prediction error was 1.2, 2.2, 2.8 and 6.2 D respectively for physician’s estimated CL power, regression, SRK/T and 32 D CL.DiscussionThe IATS study protocol reads that if an accurate refraction could not be obtained initially, a +32 D CL should be dispensed, and the lens power should subsequently refined at the earliest opportunity. If refraction is not possible, instead of using +32 D CL, we recommend using preoperative biometry to estimate CL power.ConclusionsIf accurate refraction could not be obtained initially, preoperative biometry may help to estimate CL power. IntroductionWhen fitting infant aphakic eyes with a contact lens (CL) immediately after cataract surgery, it may not always be possible to obtain an accurate refraction. For such cases there is a tendency is to insert a +32 D CL. We sought to provide guidelines for the selection of an initial CL power if retinoscopy over a diagnostic lens is not possible. When fitting infant aphakic eyes with a contact lens (CL) immediately after cataract surgery, it may not always be possible to obtain an accurate refraction. For such cases there is a tendency is to insert a +32 D CL. We sought to provide guidelines for the selection of an initial CL power if retinoscopy over a diagnostic lens is not possible. MethodsPatients with a unilateral cataract and randomized to CL treatment in the Infant Aphakia Treatment Study (IATS) were analyzed. An eye was included if there was a valid preoperative axial length (AL) measurement using immersion and a one-month postoperative refraction. Target CL power was determined using refraction (adjusting for vertex distance of 12 mm) over known CL power one-month postoperatively. We compared it with four techniques: (1) physician’s estimated CL power (defined as the prescribed CL power minus 2D overcorrection based on IATS protocol); (2) regression1, CL power = 84.4-3.2 × AL; (3) SRK/T IOL power1 calculated using a modified A-constant (112.176); (4) 32 D CL. Patients with a unilateral cataract and randomized to CL treatment in the Infant Aphakia Treatment Study (IATS) were analyzed. An eye was included if there was a valid preoperative axial length (AL) measurement using immersion and a one-month postoperative refraction. Target CL power was determined using refraction (adjusting for vertex distance of 12 mm) over known CL power one-month postoperatively. We compared it with four techniques: (1) physician’s estimated CL power (defined as the prescribed CL power minus 2D overcorrection based on IATS protocol); (2) regression1, CL power = 84.4-3.2 × AL; (3) SRK/T IOL power1 calculated using a modified A-constant (112.176); (4) 32 D CL. ResultsThere were 36 of 57 eyes that met the inclusion criteria. Age at cataract surgery was 2.3 ± 1.7months. Preoperative AL was 17.9 ± 1.6 mm. Follow-up refraction was performed at 31 ± 3 days. Target CL power based on the one-month refraction was 26.0 ± 4.4 D. Mean prediction error was 0.4, −1.0, −2.0, and 6.2 D and mean absolute prediction error was 1.2, 2.2, 2.8 and 6.2 D respectively for physician’s estimated CL power, regression, SRK/T and 32 D CL. There were 36 of 57 eyes that met the inclusion criteria. Age at cataract surgery was 2.3 ± 1.7months. Preoperative AL was 17.9 ± 1.6 mm. Follow-up refraction was performed at 31 ± 3 days. Target CL power based on the one-month refraction was 26.0 ± 4.4 D. Mean prediction error was 0.4, −1.0, −2.0, and 6.2 D and mean absolute prediction error was 1.2, 2.2, 2.8 and 6.2 D respectively for physician’s estimated CL power, regression, SRK/T and 32 D CL. DiscussionThe IATS study protocol reads that if an accurate refraction could not be obtained initially, a +32 D CL should be dispensed, and the lens power should subsequently refined at the earliest opportunity. If refraction is not possible, instead of using +32 D CL, we recommend using preoperative biometry to estimate CL power. The IATS study protocol reads that if an accurate refraction could not be obtained initially, a +32 D CL should be dispensed, and the lens power should subsequently refined at the earliest opportunity. If refraction is not possible, instead of using +32 D CL, we recommend using preoperative biometry to estimate CL power. ConclusionsIf accurate refraction could not be obtained initially, preoperative biometry may help to estimate CL power. If accurate refraction could not be obtained initially, preoperative biometry may help to estimate CL power." @default.
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• W2013116975 title "Guidelines for prescribing initial contact lens power if refraction is not possible: Analysis of subjects enrolled in the Infant Aphakia Treatment Study" @default.
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