ImportanceParents may be concerned about the adverse outcomes of occlusion therapy in children treated for unilateral congenital cataract (UCC).ObjectiveTo determine whether occlusion therapy in children treated for UCC with poor visual outcomes is negatively associated with poorer child and/or family functioning.Design, Setting, and ParticipantsThis cohort study was conducted in 2023 using data collected between 2006 and 2016 in the Infant Aphakia Treatment Study (IATS). IATS participants with a visual acuity (VA) of 20/200 or worse were included. Statistical analysis was performed from July 2022 to October 2023.ExposureCaregivers reported the mean daily minutes of patching during the 12 months prior to the VA assessment at 4.5 years of age. Patching was categorized as minimal (<15 minutes per day), moderate (15 to <120 minutes per day), or extensive (≥120 minutes per day).Main Outcome MeasuresAt 4.25 and 10.5 years of age, caregivers reported stress associated with the parenting role using the Parenting Stress Index and the Ocular Treatment Index and child behavior problems using the Achenbach Child Behavior Checklist. Motor skills were assessed at age 54 months using the Movement Assessment Battery for Children–Second Edition. Children completed the Harter Self-Perception Profile for Children at age 10.5 years. One-way analysis of variance and χ2 tests were used to compare outcomes by amount of patching.ResultsPatching data were available for 47 of 53 children (88.7%) with a VA of 20/200 or worse. Among these 47 children with patching data included in the study, 20 (42.5%) were female, 27 (57.5%) were male, 12 (25.5%) were reported to have been patched fewer than 15 minutes per day, 11 (23.4%) were patched 16 to 119 minutes per day, and 24 (51.1%) were patched at least 120 minutes per day. Parenting stress, child behavior problems, motor functioning, and child self-perception were similar in all groups. For example, after adjusting for gender and insurance status, there was a nonsignificant difference between mean stress scores of 11.0 (95% CI, −4.5 to 26.5) points for parents who reported minimal patching vs parents who reported patching at least 120 minutes per day, and there was no significant difference in children’s report of their global self-worth (0.0 [95% CI, −0.4 to 0.3] points).Conclusions and RelevanceOcclusion therapy was not negatively associated with family or child functioning. Although the sample size was limited, these results do not support changes to the current practice guidelines.

中文翻译：

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单侧先天性白内障儿童的修补以及儿童功能和养育压力

重要性家长可能会担心接受单侧先天性白内障 (UCC) 治疗的儿童的遮挡治疗的不良后果。目的确定接受 UCC 治疗且视力结果不佳的儿童的遮挡治疗是否与较差的儿童和/或家庭功能呈负相关。设计、设置和参与者这项队列研究于 2023 年进行，使用了 2006 年至 2016 年婴儿无晶体眼治疗研究 (IATS) 中收集的数据。视力 (VA) 为 20/200 或更差的 IATS 参与者也被纳入其中。统计分析的时间为 2022 年 7 月至 2023 年 10 月。ExposureCaregivers 报告了 4.5 岁时进行 VA 评估之前的 12 个月内每日平均贴敷时间。修补被分类为最小（每天<15分钟）、中度（每天15至<120分钟）或广泛（每天≥120分钟）。 主要结果测量在4.25岁和10.5岁时，护理人员使用育儿压力指数和眼部治疗指数报告与育儿角色相关的压力，并使用阿亨巴赫儿童行为检查表报告儿童行为问题。在 54 个月大时使用儿童运动评估电池第二版评估运动技能。孩子们在 10.5 岁时完成了哈特儿童自我认知概况。方差和 χ2 的单因素分析2使用测试来比较修补量的结果。结果 53 名 VA 为 20/200 或更差的儿童中的 47 名 (88.7%) 可获得修补数据。在研究中包含补丁数据的 47 名儿童中，20 名 (42.5%) 为女性，27 名 (57.5%) 为男性，12 名 (25.5%) 据报告每天打补丁时间少于 15 分钟，11 名 (23.4%) ）每天打补丁 16 至 119 分钟，24 个（51.1%）每天打补丁至少 120 分钟。所有组中的育儿压力、儿童行为问题、运动功能和儿童自我认知都相似。例如，在调整性别和保险状况后，报告最少修补的父母与报告每天修补至少 120 分钟的父母的平均压力分数为 11.0（95% CI，-4.5 至 26.5）分之间没有显着差异，并且儿童的整体自我价值报告没有显着差异（0.0 [95% CI，-0.4 至 0.3] 分）。 结论和相关性 封闭治疗与家庭或儿童功能没有负相关。尽管样本量有限，但这些结果并不支持对当前实践指南的更改。