Early Patching Benefits Kids Born With Cataract in One Eye

TOPLINE:

Children with congenital cataract in one eye are more likely to achieve nearly normal vision when their caregivers maintain consistent daily patching schedules in the first year after surgery, particularly in the morning or at regular times every day.

METHODOLOGY:

• Researchers conducted a post hoc analysis of the Infant Aphakia Treatment Study to examine the association between the reported consistency in patching during the first year after unilateral cataract surgery and visual acuity.
• They included data from 101 children whose caregivers completed 7-day patching diaries at 2 months after surgery or at age 13 months.
• The treatment protocol required caregivers to have their child wear a patch over the fellow eye for 1 hour daily from the second week after cataract surgery until age 8 months , followed by patching for 50% of waking hours until age 5 years.
• Consistent patching was defined as daily patching with an average start time before 9 AM or an interquartile range of the first application time of 60 minutes or less.
• Visual acuity in the treated eye was the primary outcome, assessed at ages 54 + 1 months and 10.5 years ; participants with a visual acuity of 20/40 or better were said to have near-normal vision.

TAKEAWAY:

• Children whose caregivers reported consistent patching patterns demonstrated better average visual acuity at ate 54 months than those whose caregivers reported inconsistent patching patterns (mean difference in logMAR visual acuity, 0.55; 95% CI, 0.22-0.87); the results were promising for children aged 10.5 years, as well.
• Data from the diary completed at age 13 months showed children whose caregivers reported patching before 9 AM or around the same time daily were more likely to achieve near-normal vision at age 54 + 1 months and 10.5 years (relative risk, 3.55; 95% CI, 1.61-7.80, and 2.31; 95% CI, 1.12-4.78, respectively) than those whose caregivers did not report such behavior.
• Children whose caregivers reported consistent vs inconsistent patching patterns achieved more average daily hours of patching both during the first year (4.82 h vs 3.50 h) and between age 12 and 48 months (4.96 h vs 3.03 h).

IN PRACTICE:

“This information can be used by healthcare providers to motivate caregivers to develop consistent patching habits. Further, providers can present caregivers with simple advice: Apply the patch every day either first thing in the morning or about the same time every day,” the authors of the study wrote.

SOURCE:

The study was led by Carolyn Drews-Botsch, PhD, MPH, of the Department of Global and Community Health at George Mason University, in Fairfax, Virginia. It was published online on December 28, 2024, in Ophthalmology.

LIMITATIONS:

The diaries covered only 14 days of the first year following surgery, which may not have fully represented patching patterns during other periods. The researchers noted that establishing a routine for patching was particularly challenging for infants aged less than 5 months at the time of the first diary completion as these infants may not yet have established regular sleep and feeding routines. Parents who participated in this trial may have differed from those in routine practice, potentially affecting the generalizability of the findings to general clinical populations.

DISCLOSURES:

This study was supported by the following grants: 1 R21 EY032152, 2 UG1 EY031287, 5 U10 EY013287, 5 UG1 EY02553, and 7 UG1 EY013272. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.