Appropriate addition power for aphakic infants determined by a smart wearable device Clouclip

It is particularly important to perform reasonable and effective optical correction to enable visual development after primary lens removal surgery for congenital cataracts. Aphakic infants need a suitable addition power of prescription (ADD) to help them focus on close visual objects. It is challenging to obtain appropriate ADD power for infants due to poor cooperation and lack of subjective feedback. We aimed to determine the appropriate ADD for aphakic infants using a recently developed smart wearable device called Clouclip. The study was a cross-sectional, observational pilot study. Twenty-three aphakic infants (aged from 6 months to 3.5 years) were invited to wear a smart wearable device for 7 days consecutively to monitor the near viewing distance in real life. Viewing habits and its associations with the possible influencing factors were investigated based on the data obtained from the device. The average proportion of near viewing time was 77.9% (95% confidence interval (CI) 72.1–83.7%). The average of the median near viewing distance was 23.8 cm (95% CI 20.6 cm-27.0 cm), which corresponded to an ADD of +4.25 D (95% CI + 3.75 D – +4.75 D) spectacle prescription. The height of the child was found to be positively correlated with the median of near viewing distance (<i>r</i> = 0.646, <i>p</i> = 0.001). Age, current ADD, age of cataract extraction surgery and bilaterality or monocularity of the aphakic eyes showed no significant correlation with the aforementioned viewing habits (all <i>p</i> &gt; 0.05). By using the novel wearable device, we found the suitable ADD of spectacle prescription for aphakic infants is about +4.25 D. The height of the child was an influencing factor for ADD.

针对先天性白内障患者行一期晶状体摘除术后，开展合理有效的光学矫正以保障术后视觉发育尤为关键。无晶状体婴儿需要适配的处方附加屈光度数（addition power，简称ADD）以实现近距离视物的清晰聚焦。但由于婴儿配合度欠佳且无法提供主观反馈，获取合适的ADD颇具挑战。本研究借助一款新近研发的智能可穿戴设备Clouclip，旨在确定无晶状体婴儿的适配ADD值。本研究为横断面观察性预试验，共纳入23名年龄介于6个月至3.5岁的无晶状体婴儿，要求其连续7日佩戴该智能可穿戴设备，以实时监测真实场景下的近距离注视距离。基于设备采集的数据，本研究对受试者的注视习惯及其与潜在影响因素的关联展开分析。研究结果显示，受试者的近距离注视时长占比均值为77.9%（95%置信区间CI：72.1%~83.7%）；中位近距离注视距离均值为23.8cm（95%置信区间CI：20.6cm~27.0cm），对应眼镜处方的ADD值为+4.25屈光度（D）（95%CI：+3.75D~+4.75D）。分析发现，儿童身高与中位近距离注视距离呈显著正相关（r=0.646，p=0.001）；而年龄、当前ADD值、白内障摘除手术年龄以及无晶状体眼的单/双眼属性与上述注视习惯均无显著相关性（所有p>0.05）。本研究通过这款新型可穿戴设备得出，无晶状体婴儿适配的眼镜处方ADD值约为+4.25D，儿童身高是影响ADD值的相关因素。