Experiences of Treatment With Contact Lenses in Aphakic Children With Unilateral Congenital Cataract: A Retrospective Study

Abstract

Background and Objectives:Congenital cataract is a condition compromising the eye's crystalline lens in infants and is usually diagnosed at birth. It can lead to irreversible vision loss if not promptly detected and treated, especially in unilateral cases. Nowadays, children with congenital cataracts can undergo surgical removal of their opacified crystalline lenses, and visual rehabilitation is mandatory to prevent deep amblyopia. Contact lenses, predominantly of rigid gas-permeable (GP) type, are gaining more popularity for this matter.Method:In this retrospective cohort study, unilateral aphakic children younger than 6 years referred to the Contact Lens Clinic at Farabi Eye Hospital from November 2011 to September 2019 were included.Results:Seventy-six unilateral aphakic children with congenital cataracts (57.9% boys and 42.1% girls) rehabilitated with GP were studied. The mean age of diagnosis and referral to the contact lens clinic were 20.0±19.8 and 32.0±24.4 weeks, respectively, while the mean follow-up time was 12.44±26.28 months. The mean visual acuity for children capable of cooperating at the last follow-up was 0.98±0.62 log MAR. Among the participants, eight children (9.7%) were diagnosed as glaucoma suspects. The mean initial base curve and power of GP lenses were 7.86±0.39 mm and 23.29±5.52 diopters, respectively. Only 21 parents (27.6%) reported nonadherence to the scheduled part-time patch program.Conclusion:The results of this study showed GP-based optical treatment after early diagnosis, surgical removal of congenital cataracts, and a long-term close follow-up to be well tolerated by children and their parents, with acceptable parents' compliance and can thus be introduced as a safe and effective method to achieve desirable visual outcomes.

Management of Contact Lenses and Visual Development in Pediatric Aphakia

“…The results of these studies indicated that despite problems such as discomfort from the rigid material, application difficulties, and the requirement of daytime use, RGPCLs are safe and effective lenses that can be used successfully in all pediatric aphakia patients, including infants. 32 , 33 , 34 , 35 , 36 , 37 …”