Peer-reviewed article
414 Behaviors and Quality of Life in Children with Neurodevelopmental Disorders Undergoing Refractive Surgery
Zdonczyk A, Tychsen L, Reynolds M ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines how refractive surgery affects children with neurodevelopmental disorders like autism who cannot tolerate glasses. Researchers measured children's adaptive behaviors, social skills, and quality of life before surgery using validated assessment tools. The preliminary findings show these children have significant difficulties with social behaviors and adaptive functioning, and their parents worry about their vision and eye health. The study aims to identify which children are most likely to benefit from refractive surgery.
Key points
- Preliminary sample of 9 children with neurodevelopmental disorders and refractive errors; 4 completed photorefractive keratectomy (PRK), 3 received phakic intraocular lens implantation, 2 awaiting surgery
- Pre-surgical Social Responsiveness Scale scores indicated moderately severe autism spectrum disorder symptoms affecting reciprocal social behaviors
- Pre-surgical adaptive functioning scores fell below the 20th percentile for age, indicating significant deficits
- Parents reported highest concerns about their child's eye condition and functional vision
- Prior research suggests refractive surgery can improve visual awareness and social interactions in this population, but this is the first study to use validated baseline measures
Limitations
This is a preliminary analysis with a small sample size (n=9) and incomplete follow-up data, so outcomes following surgery cannot yet be assessed. The study cannot demonstrate whether refractive surgery actually improves behaviors and quality of life without post-operative measurements.
Abstract
OBJECTIVES/GOALS: The goal of this project is to characterize the adaptive and social behaviors of ametropic children with neurodevelopmental disorders (NDD) including Autism Spectrum Disorder (ASD) undergoing refractive surgery due to spectacle intolerance. Eye-related quality of life and visual behaviors will also be measured. METHODS/STUDY POPULATION: This is an ongoing prospective cohort study of children with NDD who are spectacle-intolerant and undergoing refractive surgery at St. Louis Childrens Hospital starting July 2020. The method of refractive surgery (photorefractive keratectomy (PRK), phakic intraocular lens implantation (phIOL), and refractive lens exchange (RLx)) is chosen based on degree and type of refractive error, astigmatism, and characteristics of the cornea and anterior chamber. Behaviors are characterized using the Adaptive Behavioral Assessment System, 3rd edition (ABAS-3) and Social Responsiveness Scale, 2nd edition (SRS-2), completed by parents/caregivers. Eye-related quality of life is measured using the pediatric Eye Questionnaire (PedEyeQ). Visual behaviors are assessed with optokinetic nystagmus tracking. RESULTS/ANTICIPATED RESULTS: In a preliminary sample of 9 patients, 4 have undergone PRK, 3 phIOL, and 2 are awaiting surgery. Pre-surgical SRS-2 scores had a median t-score of 70 (range 57 to 90), indicating a clinically significant deficiency in reciprocal social behaviors as this score is consistent with moderately severe ASD. Pre-surgical ABAS-3 scores had a median General Adaptive Composite (GAC) of 51 (range 48 to 74.5). This corresponds to a percentile of 0.100 (range <0.1 to 19th percentile for age). As rated by the Parental PedEyeQ, the domains most affected were “Parent Worry About Childs Eye Condition” (median 42.0, range 15.0 to 80.0) and “Parent Worry About Functional Vision” (median 18.8, range 3.2 to 68.7), where 0 represents the worst quality of life or functional vision and 100 the best. DISCUSSION/SIGNIFICANCE: Prior research has shown that refractive surgery can improve observed visual awareness, attentiveness, or social interactions in children with NDD. This is the first study to characterize the baseline adaptive/social behaviors and quality of life using validated surveys, with the goal of subsequently identifying patients most likely to benefit.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Refractive surgery (photorefractive keratectomy, phakic intraocular lens implantation, or refractive lens exchange) chosen based on type and degree of refractive error and corneal characteristics
- Population
- Children with neurodevelopmental disorders including autism spectrum disorder who are spectacle-intolerant and have refractive errors
Key finding
Pre-surgical Social Responsiveness Scale median t-score of 70 indicating moderately severe autism symptoms