Visual outcome following the reduction or cessation of patching therapy after early unilateral cataract surgery

Objective: To evaluate the impact on visual acuity of reducing or abandoning patching therapy during the first 6 years of life following early unilateral cataract surgery. Methods: We reviewed the medical records of 9 children with unilateral congenital cataracts who underwent cataract surgery when 6 weeks or younger. All had good compliance with optical correction until 6 years of age and with patching therapy until at least 12 months of age. Results: The children underwent cataract surgery at a mean (SD) age of 21.7 (9.5) days. At 12 months of age, the children were patched a mean (SD) of 6.7 (2.4) hours/d. Patching compliance declined steadily thereafter. By 6 years of age, they were only being patched a mean (SD) of 1.7 (2.0) hours/d. Four of the 9 children abandoned patching prior to the 6-year examination. Acuities improved or remained the same for 3 of these children but worsened for 1 child by 2 lines. Conclusion: Our study suggests that some children who undergo early unilateral cataract surgery and are compliant with their optical correction and patching during early childhood can maintain a good visual outcome even if patching therapy is reduced or discontinued prior to their sixth birthday.