Contact Lens Department, Unit of Medical Research Foundation, India; Elite School of Optometry, India.
Cont Lens Anterior Eye. 2022 Feb;45(1):101531. doi: 10.1016/j.clae.2021.101531. Epub 2021 Nov 1.
To investigate the outcome of contact lens (CL) fitting in aphakic children following lensectomy for congenital cataract.
Retrospective data of 205 aphakic children who visited for CL fitting following lensectomy from 2008 to 2018 were collected. Data includes the demographic details, CL parameters in first and last visit, hours of CL wear, reason for discontinuation of CL, surgical procedures underwent and years of follow up.
205 (148 unilateral and 57 bilateral) aphakic children comprised of age group, < 1 month (n = 48), 1-3 months (n = 37), 3-6 months (n = 68), 6-12 months (n = 10), >12 months (n = 42). 173/205(84.39%) children were fitted with rigid gas permeable (RGP) and 32/205(15.6%) were fitted with soft CL at their first visit. 10 children had shifted to soft CL in their follow-up visits due to intolerance to RGP. 97/205(47.32%) children continued CL (55RGP, 42SCL) till the last follow-up for 2.17 ± 2.36 years and wore lens for 3.7 ± 3.65 h per day. Number of lenses replaced was 2 lenses (median) and maximum of 9 lenses over a period of 1-8 visits. The maximum visual acuity achieved was up to 0.2 log Mar units at the youngest age of 4 years on successful CL wear. 60/205(29.26%) children discontinued lenses at different follow-up visits due to IOL implantation(n = 28),using spectacles due to handling difficulty, child uncooperative to lens wear and lens fitting issues(n = 32). 48/205(23.41%) were lost to follow-up after the first visit. The average K (7.46 ± 0.43 mm) showed significant correlation to lens base curve in first visit (7.48 ± 0.41 mm) whereas flat K (7.71 ± 0.38 mm) showed significant correlation in the last visit (7.46 ± 0.39 mm) (p < 0.005). This was well described by a significant diameter change of 8.68 ± 0.31 mm to 9.42 ± 1.77 mm (p < 0.005) at the first and last visit respectively. The refractive error showed a significant difference between first (27.96 ± 5.33D) and last visit (21.97 ± 6.85D) (p < 0.005).
This study witnessed successful contact lens wear in only half of the children. The visual rehabilitation following lensectomy depends on right CL choice and close follow-up.
研究先天性白内障晶状体切除术后戴隐形眼镜（CL）治疗无晶状体眼儿童的结果。
回顾性收集 2008 年至 2018 年期间因晶状体切除术后戴隐形眼镜而就诊的 205 例无晶状体儿童的资料。数据包括人口统计学细节、首次和最后一次就诊时的 CL 参数、CL 佩戴时间、停止 CL 佩戴的原因、接受的手术程序和随访年限。
205 例（148 例单侧和 57 例双侧）无晶状体儿童的年龄分组为：<1 个月（n=48）、1-3 个月（n=37）、3-6 个月（n=68）、6-12 个月（n=10）、>12 个月（n=42）。205 例儿童中，173 例（84.39%）首次就诊时配硬性透气性隐形眼镜（RGP），32 例（15.6%）首次就诊时配软性隐形眼镜。10 例因不能耐受 RGP 在随访中改为软性隐形眼镜。97 例（47.32%）儿童继续佩戴隐形眼镜（55 例 RGP，42 例 SCL）至最后一次随访，随访时间为 2.17±2.36 年，每天佩戴隐形眼镜 3.7±3.65 小时。更换隐形眼镜的次数为 2 副（中位数），在 1-8 次就诊期间最多更换 9 副。在最小年龄 4 岁时，成功佩戴隐形眼镜后可达到最大视力 0.2 对数 MAR 单位。60 例（29.26%）儿童因植入人工晶状体（n=28）、因处理困难戴眼镜（n=32）、儿童不配合佩戴隐形眼镜和隐形眼镜适配问题（n=32），在不同随访期间停止佩戴隐形眼镜。48 例（23.41%）儿童在首次就诊后失访。平均角膜曲率（K）值（7.46±0.43mm）在首次就诊时与镜片基弧（7.48±0.41mm）显著相关，而扁平角膜曲率（K）值（7.71±0.38mm）在最后一次就诊时与镜片基弧（7.46±0.39mm）显著相关（p<0.005）。这与首次就诊时直径从 8.68±0.31mm 显著变化到 9.42±1.77mm（p<0.005）和最后一次就诊时直径从 8.68±0.31mm 显著变化到 9.42±1.77mm（p<0.005）相一致。屈光度在首次就诊时（27.96±5.33D）和最后一次就诊时（21.97±6.85D）有显著差异（p<0.005）。
本研究发现只有一半的儿童成功佩戴隐形眼镜。晶状体切除术后的视觉康复取决于正确的隐形眼镜选择和密切随访。
