Book reviews Leff, Michael C.; Oravec, Christine; Duffy, Bernard K. ...
Quarterly Journal of Speech,
19/8/1/, Letnik:
69, Številka:
3
Book Review
Recenzirano
EXPLORATIONS IN RHETORIC: STUDIES IN HONOR OF DOUGLAS EHNINGER Edited by Ray E. McKerrow. Editorial Committee: James R. Irvine, Donovon Ochs, Michael Osborn, Marilyn J. Van Graber. Glenview, Ill.: ...Scott, Foresman and Co., 1982; pp. vii + 184. $10.95.
AMERICAN RHETORIC FROM ROOSEVELT TO REAGAN. Edited with critical studies by Halford Ross Ryan. Prospect Heights, Ill.: Waveland Press, 1983; pp. xv + 309. $10.95 paper.
THE RHETORIC OF CONSERVATISM: THE VIRGINIA CONVENTION OF 1829-30 AND THE CONSERVATIVE TRADITION IN THE SOUTH. By Dickson D. Bruce, Jr. San Marino: The Huntington Library, 1982; pp. xxi + 218. $18.00.
THE RHETORIC OF PROTEST AND REFORM: 1878-1898. Edited by Paul H. Boase. Athens: Ohio University Press, 1980; pp. 354. $18.95.
ATTLEE. By Kenneth Harris. London: Weidenfeld & Nicolson, 1982; pp. 630. £14.95.
SHAPING THE FIRST AMENDMENT: THE DEVELOPMENT OF FREE EXPRESSION. By John D. Stevens. Beverly Hills: Sage Publications, 1982; pp. 156. $7.95.
POSITIVE IMAGES: BREAKING STEREOTYPES WITH CHILDREN'S TELEVISION. By Jerome Johnston and James S. Ettema. Beverly Hills: Sage Publications, 1982; pp. 263. $10.95 paper.
GETTING TOGETHER: A GUIDE FOR GOOD GROUPS. By Em Griffin. Downers Grove, Ill.: InterVarsity Press, 1982; pp. 233. $5.95.
Book reviews Ivie, Robert L.; King, Andrew; Heath, Robert L. ...
Quarterly Journal of Speech,
19/2/1/, Letnik:
77, Številka:
1
Book Review
Recenzirano
I. A. RICHARDS; HIS LIFE AND WORK. By John Paul Russo. Baltimore: The Johns Hopkins University Press, 1989, pp. xx + 843. $39.95.
THE LEGACY OF KENNETH BURKE. Edited by Herbert W. Simons and Trevor ...Melia. Madison: University of Wisconsin Press, 1989; pp. v + 331. $37.50; paper $15.95.
WHOSE JUSTICE? WHICH RATIONALITY? By Alasdair Maclntyre. Notre Dame: University of Notre Dame Press, 1988; pp. xi + 410. $22.95.
CRITICAL SOCIAL SCIENCE: LIBERATION AND ITS LIMITS. By Brian Fay. Ithaca, New York: Cornell University Press, 1987; pp. x + 242. $35.00; paper $12.95.
PSYCHOSEMANTICS: THE PROBLEM OF MEANING IN THE PHILOSOPHY OF MIND. By Jerry A. Fodor. Cambridge, MA: MIT Press, 1987; pp. ix + 154. $19.95.
LANGUAGE AND REPRESENTATION: A SOCIO-NATURALISTIC APPROACH TO HUMAN DEVELOPMENT. By Chris Sinha. New York: New York University Press, 1988; pp. xix + 235. $35.00.
PEIRCE'S APPROACH TO THE SELF: A SEMIOTIC PERSPECTIVE ON HUMAN SUBJECTIVITY. By Vincent M. Colapietro. Albany: State University of New York Press, 1989; pp. xxi + 141. $34.50; paper $10.95.
THE SEMEIOSIS OF POETIC METAPHOR. By Michael Cabot Haley. Bloomington: Indiana University Press, 1988; pp. xi + 178. $25.00.
INTERPRETIVE ACTS: IN SEARCH OF MEANING. By Wendell V. Harris. Oxford: Clarendon Press, 1988; pp. vii+ 192. $32.50.
EVOLUTION AND CONSCIOUSNESS: THE ROLE OF SPEECH IN THE ORIGIN AND DEVELOPMENT OF HUMAN NATURE. By Leslie Dewart. Toronto: University of Toronto Press, 1989; pp. xii + 399. $50.00.
ABRAHAM LINCOLN: PUBLIC SPEAKER. By Waldo W. Braden. Baton Rouge: Louisiana State University Press, 1988; pp. viii + 119. $19.95.
EUGENE TALMADGE: RHETORIC AND RESPONSE. By Calvin McLeod Logue. Westport, Conn.: Greenwood Press, 1989; pp. xviii + 307. $45.00.
COMMUNICATION AND LITIGATION: CASE STUDIES OF FAMOUS TRIALS. By Janice Schuetz and Kathryn Holmes Snedaker. Foreward by Peter E. Kane. Carbondale and Edwardsville: Southern Illinois University Press, 1988; pp. xvii + 277. $24.95.
SHOULD AMERICA GO TO WAR? THE DEBATE OVER FOREIGN POLICY IN CHICAGO, 1939-1941. By James C. Schneider. Chapel Hill: The University of North Carolina Press, 1989; pp. xx + 224. $37.50.
RECASTING AMERICA: CULTURE AND POLITICS IN THE AGE OF COLD WAR. Edited by Lary May. Chicago: Univ. of Chicago Press, 1989; pp. x + 310. $49.95; paper $15.95.
THE TRUTH OF AUTHORITY: IDEOLOGY AND COMMUNICATION IN THE SOVIET UNION. By Thomas F. Remington. Pittsburgh: University of Pittsburgh Press, 1988; pp. xv + 255. $29.95; paper $12.95.
FLIGHTS OF FANCY, FLIGHTS OF DOOM: KAL 007 AND SOVIET-AMERICAN RHETORIC. By Marilyn J. Young and Michael K. Launer. Lanham: University Press of America, 1988; pp. xxvi + 333. $29.50; paper $18.20.
HISTORY/WRITING: THE THEORY AND PRACTICE OF HISTORY IN ANTIQUITY AND IN MODERN TIMES. By Albert Cook. Cambridge: Cambridge University Press, 1988; pp. x + 275. $39.50.
WHY LEADERS CAN'T LEAD: THE UNCONSCIOUS CONSPIRACY CONTINUES. By Warren Bennis. San Francisco: Jossey-Bass Publishers, 1989; pp. xix + 169. $19.95.
WOMEN COMMUNICATING: STUDIES OF WOMEN'S TALK. Edited by Barbara Bate and Anita Taylor. Norwood, New Jersey: Ablex Publishing Company, 1988; pp. ix + 321. $45.00; paper $27.50.
LIFE METAPHORS: STORIES OF ORDINARY SURVIVAL. By Catherine Sullivan Norton. Carbon-dale: Southern Illinois University Press, 1989; pp. xvii + 229. $24.95.
THE COUNTRY MUSIC MESSAGE: REVISITED. By Jimmie N. Rogers. Fayetteville: University of Arkansas Press, 1989; pp. xiv + 268. $20.00.
INVENTING AMERICAN BROADCASTING, 1899-1922. By Susan J. Douglas. Baltimore: The Johns Hopkins University Press, 1987; pp. xxix + 363. $29.50.
TELEVANGELISM: THE MARKETING OF POPULAR RELIGION. By Razelle Frankl. Carbondale: Southern Illinois University Press, 1987; pp. xvi + 204. $19.95.
PERSONALITY AND INTERPERSONAL COMMUNICATION. Edited by James C. McCros-key & John A. Daly. Newbury Park, CA: Sage Publications, 1987; pp. 352. $29.95; paper, $14.95.
Book reviews Hauser, Gerard A.; Hawes, Leonard C.; Wilson, Gerald L. ...
Quarterly Journal of Speech,
19/8/1/, Letnik:
74, Številka:
3
Book Review
Recenzirano
HUMAN COMMUNICATION AS NARRATION: TOWARD A PHILOSOPHY OF REASON, VALUE, AND ACTION. By Walter R. Fisher. Columbia: University of South Carolina Press, 1987; pp. xiv + 201. $24.95.
SCIENCE, LANGUAGE ...AND THE HUMAN CONDITION. By Morton Kaplan. New York: Paragon House Publishing, 1984; pp. 1 + 394. $27.95.
RESEARCH INTERVIEWING. By Elliot G. Mishler. Cambridge and London: Harvard University Press, 1986; pp. xi + 189. $20.00.
POWER IN THE ORGANISATION: THE DISCOURSE OF POWER IN MANAGERIAL PRAXIS. By Philippe Daudi. Oxford: Basil Blackwell, 1986; pp. vii + 338. $49.95.
HOW INSTITUTIONS THINK. By Mary Douglas. New York: Syracuse University Press, 1986; pp. xi + 146. $19.95; paper $10.95.
A NEW DIVERSITY IN CONTEMPORARY SOUTHERN RHETORIC. Edited by Calvin M. Logue and Howard Dorgan. Baton Rouge: Louisiana State University Press, 1987; pp. vii + 268. $32.50.
TO REDEEM THE SOUL OF AMERICA: THE SOUTHERN CHRISTIAN LEADERSHIP CONFERENCE AND MARTIN LUTHER KING, JR. By Adam Fairclough. Athens, Georgia: University of Georgia Press, 1987; pp. x + 504. $35.00; paper $17.95.
GUNNAR MYRDAL AND BLACK-WHITE RELATIONS: THE USE AND ABUSE OF AN AMERICAN DILEMMA, 1944-1969. By David W. Southern. Baton Rouge: Louisiana State University Press, 1987; pp. xviii + 341. $35.00.
THINKING IN TIME: THE USES OF HISTORY FOR DECISION MAKERS. By Richard E. Neustadt and Ernest R. May. New York: The Free Press, 1986; pp. xxii + 329. $19.95.
INFLUENCE: SCIENCE AND PRACTICE. By Robert B. Cialdini. Glenview, Illinois: Scott, Foresman and Company, 1985; pp. 264. $12.65.
ACTUAL MINDS, POSSIBLE WORLDS. By Jerome Bruner. Cambridge: Harvard University Press, 1986; pp. xi + 201. $15.00.
COGNITIVE FOUNDATIONS OF CALCULATED SPEECH: CONTROLLING UNDERSTANDINGS IN CONVERSATION AND PERSUASION. By Robert E. Sanders. Albany: State University of New York Press, 1986; pp. xii + 273. $39.50; paper $14.95.
COMMUNICATION: STRATEGIC ACTION IN CONTEXT. By Beth Haslett. Hillsdale, New Jersey: Lawrence Erlbaum Associates, 1987; pp. xiii + 287. $29.95.
CONTEMPORARY PERSPECTIVES ON RHETORIC. By Sonja K. Foss, Karen A. Foss, and Robert Trapp. Prospect Heights, IL: Waveland Press, 1985; pp. v + 330. Paper $12.95.
LINGUISTIC CRITICISM. By Roger Fowler. New York: Oxford University Press, 1986; pp. 190. $24.95; paper $9.95.
WORDS AND THE WORD: LANGUAGE, POETICS AND BIBLICAL INTERPRETATION. By Stephen Prickett. New York: Cambridge University Press, 1986; pp. ix + 305. $39.00.
STYLE AS ARGUMENT: CONTEMPORARY AMERICAN NONFICTION. By Chris Anderson. Carbondale: Southern Illinois University Press, 1987; pp. x + 190. $19.95; paper $10.95.
IMAGE AS INSIGHT: VISUAL UNDERSTANDING IN WESTERN CHRISTIANITY AND SECULAR CULTURE. By Margaret R. Miles. Boston: Beacon Press, 1985; pp. xiii + 200. $27.95.
THE MUSE LEARNS TO WRITE: REFLECTIONS ON ORALITY AND LITERACY FROM ANTIQUITY TO THE PRESENT. By Eric A. Havelock. New Haven: Yale University Press, 1986; pp. 144. $16.00.
WOMEN, MEN AND LANGUAGE. By Jennifer Coates. London and New York: Longman, 1986; pp. 178. paper $10.95.
NO IVORY TOWER: MC CARTHYISM AND THE UNIVERSITIES. By Ellen W. Schrecker. New York: Oxford University Press, 1986; pp. ix + 437. $20.95.
THE MAIN SOURCE: LEARNING FROM TELEVISION NEWS. By John P. Robinson and Mark R. Levy. Beverly Hills: Sage, 1986; pp. 272. $28.00; paper $14.00.
POLITICAL PERSUASION IN PRESIDENTIAL CAMPAIGNS. Edited by L. Patrick Devlin. New Brunswick, NJ: Transaction Books, 1987; pp. 218. $29.95.
RONALD REAGAN, THE MOVIE AND OTHER EPISODES IN POLITICAL DEMONOLOGY. By Michael Rogin. Berkeley: University of California Press, 1987; pp. vii + 366. $25.00.
WAR AS ADVERTISED: THE FOUR MINUTE MEN AND AMERICA'S CRUSADE 1917-1918. By Alfred E. Cornebise. Philadelphia: American Philosophical Society, 1984; pp. xi + 181. Paper $15.00.
PROPAGANDA, PERSUASION, AND POLEMIC. Edited by Jeremy Hawthorne. London: Edward Arnold Ltd., 1987; pp. vii + 176.
THE SOUTHERN ESSAYS OF RICHARD M. WEAVER. Edited by George M. Curtis, III and James J. Thompson, Jr. Indianapolis: Liberty Press, 1987. pp. xxii + 268; $10.00; paper $4.50.
EDMUND BURKE AND THE PRACTICE OF POLITICAL WRITING. By Christopher Reid. New York: St. Martin's Press, 1986; pp. xiii + 238. $27.50.
INTERPRETATION AND SOCIAL CRITICISM. By Michael Walzer. Cambridge, MA: Harvard University Press, 1987; pp. viii + 96. $12.50.
CRITICISM AND TRUTH. By Roland Barthes. Translated and Edited by Katrine Pilcher Keuneman. Introduction by Philip Thody. Minneapolis: University of Minnesota Press, 1987; pp. 7-119. $25.00; paper $10.95.
WHAT STORIES ARE: NARRATIVE THEORY AND INTERPRETATION. By Thomas M. Leitch. University Park and London: Pennsylvania State University Press, 1986; pp. x + 222. $22.95.
Climate change is a world‐wide threat to biodiversity and ecosystem structure, functioning and services. To understand the underlying drivers and mechanisms, and to predict the consequences for ...nature and people, we urgently need better understanding of the direction and magnitude of climate change impacts across the soil–plant–atmosphere continuum. An increasing number of climate change studies are creating new opportunities for meaningful and high‐quality generalizations and improved process understanding. However, significant challenges exist related to data availability and/or compatibility across studies, compromising opportunities for data re‐use, synthesis and upscaling. Many of these challenges relate to a lack of an established ‘best practice’ for measuring key impacts and responses. This restrains our current understanding of complex processes and mechanisms in terrestrial ecosystems related to climate change.
To overcome these challenges, we collected best‐practice methods emerging from major ecological research networks and experiments, as synthesized by 115 experts from across a wide range of scientific disciplines. Our handbook contains guidance on the selection of response variables for different purposes, protocols for standardized measurements of 66 such response variables and advice on data management. Specifically, we recommend a minimum subset of variables that should be collected in all climate change studies to allow data re‐use and synthesis, and give guidance on additional variables critical for different types of synthesis and upscaling. The goal of this community effort is to facilitate awareness of the importance and broader application of standardized methods to promote data re‐use, availability, compatibility and transparency. We envision improved research practices that will increase returns on investments in individual research projects, facilitate second‐order research outputs and create opportunities for collaboration across scientific communities. Ultimately, this should significantly improve the quality and impact of the science, which is required to fulfil society's needs in a changing world.
RESUMEN
El cambio climático es una amenaza global para la biodiversidad, la estructura y funcionamiento de los ecosistemas y la habilidad de éstos para generar servicios ecosistémicos. Para poder comprender las causas y los mecanismos subyacentes, y poder predecir las consecuencias del cambio climático tanto para la naturaleza como para los seres humanos, debemos entender la magnitud y dirección de estos cambios a través del continuo suelo‐planta‐atmósfera. El creciente número de estudios sobre cambio climático brinda nuevas oportunidades para poder generalizar de forma más robusta y entender mejor los procesos implicados. Sin embargo, todavía hay grandes obstáculos en cuanto a la disponibilidad de datos y cómo de compatibles son los distintos estudios, que ponen en riesgo las oportunidades para reutilizar y sintetizar datos y comparar a distintas escalas. Estos obstáculos limitan nuesta habilidad para comprender los complejos procesos y mecanismos relacionados con el cambio climático en ecosistemas terrestres.
Para superar estos obstáculos, hemos recopilado recomendaciones metodológicas basadas en las mejores prácticas propuestas por las principales redes de investigación en ecología, avalados por 115 expertos de un amplio rango de disciplinas científicas. Nuestro manual contiene recomendaciones para la selección de variables respuesta para diferentes propósitos, y protocolos para realizar medidas estandarizadas de 66 posibles variables respuesta, así como sugerencias para la gestión de los datos obtenidos. Recomendamos específicamente un mínimo de variables que deben medirse en todos los estudios sobre cambio climático para permitir la reutilización y síntesis de datos. Además, sugerimos una serie de variables adicionales que pueden ser relevantes para distintos tipos de síntesis y para la comparación a distintas escalas. El objetivo de este esfuerzo comunitario es concienciar sobre la importancia de la aplicación de métodos estandarizados para facilitar la reutilización, disponibilidad, compatibilidad y transparencia de los datos. Mejorar las prácticas de investigación aumentará la eficiencia de proyectos de investigación individuales, facilitará resultados de investigación de segundo orden y creará oportunidades para la colaboración entre comunidades científicas. Por último, estas prácticas mejorarán considerablemente la calidad y el impacto de la ciencia, que se requiere para satisfacer las necesidades de la sociedad en un mundo cambiante.
摘要
气候变化正在对全球生物多样性, 生态系统结构, 功能和服务造成严重的威胁。为了理解这一过程的潜在驱动和机制, 以及预测这一过程对自然和人类社会的影响, 我们迫切的需要更好的了解气候变化对土壤‐植物‐大气系统影响的方向和强度。不断增加的相关方向的研究正在使对该研究领域的数据进行广泛而有意义的概括和总结成为可能, 从而进一步提高我们对这一重要过程的理解。然而, 显著的挑战依然存在, 特别是不同的生态研究产生的数据的可获得性和兼容性有着巨大差异, 这在一定程度上限制了研究数据的再度利用, 概括总结以及进一步推广应用。这个挑战与我们在观测气候变化和生态系统的关键影响及响应时缺乏良好的“最佳实践”有关。这个问题在很大程度上限制了我们对气候变化背景下陆地生态系统的复杂过程和机制的理解。
为了克服这些挑战, 我们收集了基于115个不同陆地生态研究领域的专家总结的主要生态研究网络和试验中的“最佳实践”方法。我们建立的“最佳实践”手册包括了对不同研究目的下选择测量的生态响应变量的建议, 测量66个生态响应变量的标准化流程, 以及如何进行数据管理的建议。特别地, 为了达到研究数据的可再度利用和融合, 我们推荐了一个在所有相关陆地生态研究中必须收集的最小数据集。同时针对不同类型的数据融合和推广应用, 我们给出了额外的关键数据和变量的收集建议。我们的工作希望能够有助于提高该研究领域的研究者对数据标准化的重要性和广泛应用的认识, 从而促进数据的再度利用, 数据的可获得性, 兼容性和透明度。我们期望改进的研究实践将能够增加每一个研究项目的投资回报率, 促进科研数据的二度产出, 以及创造更多的跨研究领域, 跨学科的合作机会。并最终, 显著提高我们的科学研究的质量和影响力, 以满足全球变化下社会对相关科学成果的需求。
Background and purpose
Acute ischemic stroke has increasingly become a procedural disease following the demonstrated benefit of mechanical thrombectomy (MT) for emergent large vessel occlusion (ELVO) ...on clinical outcomes and tissue salvage in randomized trials. Given these data and anecdotal experience of decreased numbers of decompressive hemicraniectomies (DHCs) performed for malignant cerebral edema, we sought to correlate the numbers of strokes, thrombectomies, and DHCs performed over the timeline of the 2013 failed thrombolysis/thrombectomy trials, to the 2015 modern randomized MT trials, to post-DAWN and DEFUSE 3.
Materials and methods
This is a multicenter retrospective compilation of patients who presented with ELVO in 11 US high-volume comprehensive stroke centers. Rates of tissue plasminogen activator (tPA), thrombectomy, and DHC were determined by current procedural terminology code, and specificity to acute ischemic stroke confirmed by each institution. Endpoints included the incidence of stroke, thrombectomy, and DHC and rates of change over time.
Results
Between 2013 and 2018, there were 55,247 stroke admissions across 11 participating centers. Of these, 6145 received tPA, 4122 underwent thrombectomy, and 662 patients underwent hemicraniectomy. The trajectories of procedure rates over time were modeled and there was a significant change in MT rate (p = 0.002) without a concomitant change in the total number of stroke admissions, tPA administration rate, or rate of DHC.
Conclusions
This real-world study confirms an increase in thrombectomy performed for ELVO while demonstrating stable rates of stroke admission, tPA administration and DHC. Unlike prior studies, increasing thrombectomy rates were not associated with decreased utilization of hemicraniectomy.
Cataract is an important cause of visual impairment in children. Data from a large pediatric cataract surgery registry can provide real-world estimates of visual outcomes and the 5-year cumulative ...incidence of adverse events.
To assess visual acuity (VA), incidence of complications and additional eye operations, and refractive error outcomes 5 years after pediatric lensectomy among children younger than 13 years.
This prospective cohort study used data from the Pediatric Eye Disease Investigator Group clinical research registry. From June 2012 to July 2015, 61 eye care practices in the US, Canada, and the UK enrolled children from birth to less than 13 years of age who had undergone lensectomy for any reason during the preceding 45 days. Data were collected from medical record reviews annually thereafter for 5 years until September 28, 2020.
Lensectomy with or without implantation of an intraocular lens (IOL).
Best-corrected VA and refractive error were measured from 4 to 6 years after the initial lensectomy. Cox proportional hazards regression was used to assess the 5-year incidence of glaucoma or glaucoma suspect and additional eye operations. Factors were evaluated separately for unilateral and bilateral aphakia and pseudophakia.
A total of 994 children (1268 eyes) undergoing bilateral or unilateral lensectomy were included (504 51% male; median age, 3.6 years; range, 2 weeks to 12.9 years). Five years after the initial lensectomy, the median VA among 701 eyes with available VA data (55%) was 20/63 (range, 20/40 to 20/100) in 182 of 316 bilateral aphakic eyes (58%), 20/32 (range, 20/25 to 20/50) in 209 of 386 bilateral pseudophakic eyes (54%), 20/200 (range, 20/50 to 20/618) in 124 of 202 unilateral aphakic eyes (61%), and 20/65 (range, 20/32 to 20/230) in 186 of 364 unilateral pseudophakic eyes (51%). The 5-year cumulative incidence of glaucoma or glaucoma suspect was 46% (95% CI, 28%-59%) in participants with bilateral aphakia, 7% (95% CI, 1%-12%) in those with bilateral pseudophakia, 25% (95% CI, 15%-34%) in those with unilateral aphakia, and 17% (95% CI, 5%-28%) in those with unilateral pseudophakia. The most common additional eye surgery was clearing the visual axis, with a 5-year cumulative incidence of 13% (95% CI, 8%-17%) in participants with bilateral aphakia, 33% (95% CI, 26%-39%) in those with bilateral pseudophakia, 11% (95% CI, 6%-15%) in those with unilateral aphakia, and 34% (95% CI, 28%-39%) in those with unilateral pseudophakia. The median 5-year change in spherical equivalent refractive error was -8.38 D (IQR, -11.38 D to -2.75 D) among 89 bilateral aphakic eyes, -1.63 D (IQR, -3.13 D to -0.25 D) among 130 bilateral pseudophakic eyes, -10.75 D (IQR, -20.50 D to -4.50 D) among 43 unilateral aphakic eyes, and -1.94 D (IQR, -3.25 D to -0.69 D) among 112 unilateral pseudophakic eyes.
In this cohort study, development of glaucoma or glaucoma suspect was common in children 5 years after lensectomy. Myopic shift was modest during the 5 years after placement of an intraocular lens, which should be factored into implant power selection. These results support frequent monitoring after pediatric cataract surgery to detect glaucoma, visual axis obscuration causing reduced vision, and refractive error.
Cataract is an important cause of visual impairment in children. Outcomes reported from a large clinical disease-specific registry can provide real-world estimates of visual outcomes and rates of ...adverse events in clinical practice.
To describe visual acuity and refractive error outcomes, as well as rates of amblyopia, glaucoma, and additional eye surgery, during the first year after lensectomy in children.
A prospective observational study was conducted from June 18, 2012, to July 8, 2015, at 61 pediatric eye care practices among 880 children younger than 13 years at the time of lensectomy in at least 1 eye with follow-up within 15 months after surgery. Statistical analysis was performed from December 12, 2016, to December 14, 2018.
Lensectomy with or without implantation of an intraocular lens.
Visual acuity as well as rates of amblyopia, glaucoma, suspected glaucoma, and other intraocular surgery.
Among the 880 children (432 girls and 448 boys; mean SD age at annual follow-up, 4.9 3.8 years) in the study, lens surgery was bilateral in 362 (41.1%; 95% CI, 37.9%-44.4%) children and unilateral in 518 (58.9%; 95% CI, 55.6%-62.1%). An intraocular lens was implanted in 654 of 1132 eyes (60.2%; 95% CI, 57.0%-63.4% proportions reported for eye-level outcomes account for the potential correlation induced by enrolling both eyes of some individuals; for participants who received bilateral surgery, these numbers will differ from the quotient of the number of cases divided by the total sample size). Amblyopia was identified in 449 children (51.0%; 95% CI, 47.7%-54.3%). In children age 3 years or older, mean visual acuity was 0.30 logMAR (about 20/40) in 153 bilateral pseudophakic eyes, 0.49 logMAR (about 20/63) in 141 unilateral pseudophakic eyes, 0.47 logMAR (about 20/63) in 21 bilateral aphakic eyes, and 0.61 logMAR (about 20/80) in 17 unilateral aphakic eyes. Mean visual acuity improved with older age at surgery in eyes with bilateral pseudophakia by 0.2 logMAR line (99% CI, 0.02-0.4; P = .005) and by 0.3 logMAR line (99% CI, 0.04-0.60; P = .004) in eyes with unilateral pseudophakia. A new diagnosis of glaucoma or suspected glaucoma was made in 67 of 1064 eyes that did not have glaucoma prior to lensectomy (5.9%; 95% CI, 4.6%-7.7%); 36 of 273 eyes with bilateral aphakia (13.2%; 95% CI, 9.0%-19.0%), 5 of 308 eyes with bilateral pseudophakia (1.5%; 95% CI, 0.6%-4.2%), 14 of 178 eyes with unilateral aphakia (7.9%; 95% CI, 4.7%-12.8%), and 12 of 305 eyes with unilateral pseudophakia (3.9%; 95% CI, 2.2%-6.8%). Additional intraocular surgery, most commonly vitrectomy or membranectomy to clear the visual axis, was performed in 189 of 1132 eyes (17.0%; 95% CI, 14.8%-19.6%).
Amblyopia was frequently observed during the first year after lensectomy in this cohort of children younger than 13 years. For children age 2 years or older at surgery visual acuity was typically less than normal for age and was worse with unilateral cataract. Management of visual axis obscuration was the most common complication requiring surgical intervention during the first year after surgery.
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