To the Editor We read with interest the article on 4.5-year visual acuity outcomes for the Infant Aphakia Treatment Study (IATS).1 This is clearly a well-thought-out and meticulously devised study.
The authors state that the study follows the intention-to-treat principle. We feel that as not all the study participants met the outcome criteria, this study does not fit the definition of an intention-to-treat study, which should include all the participants. For example, only the participants who had at least 3 adherence assessments were included in the analysis.