Primary IOL implantation in children: the effect of the Infant Aphakia Treatment Study on practice patterns.

We report the long-term effects on practice patterns at a single institution before (1995-2004) and after (2009-2018) publication of the results of the Infant Aphakia Treatment Study (IATS). The medical records of children <7 months of age who underwent cataract surgery at the Medical University of South Carolina were reviewed. The main outcome measure was the treatment with primary IOL or primary aphakia at the time of surgery. A total of 273 eyes of 183 patients were analyzed. Of the unilaterally affected eyes, primary IOL was the treatment of choice in 28 of the pre-IATS cases (61%) and 3 of the post-IATS cases (6%). In bilaterally affected eyes, primary IOL was the treatment of choice in 18 of the pre-IATS cases (47%) and 11 of the post-IATS cases (23%). According to a year-wise calculation, treatment with primary IOL began to decrease in 2010 and 2011, following publication of the 1-year results of the IATS in 2010. A drastic decrease in primary IOL occurred in 2015, following publication of the 5-year results.