University of Houston College of Optometry, Houston, Texas.
The Ohio State University College of Optometry, Columbus, Ohio.
Optom Vis Sci. 2022 Jun 1;99(6):505-512. doi: 10.1097/OPX.0000000000001902. Epub 2022 Apr 12.
Children are being fitted at younger ages with soft contact lenses for myopia control. This 3-year investigation of adverse events related to contact lens wear in 7- to 11-year-old participants helps optometrists understand what to expect when fitting children with soft contact lenses.
The purpose of this article is to report the frequency and type of ocular and nonocular adverse events related to soft contact lens wear in children.
Seven- to 11-year-old children wore soft contact lenses for 3 years. Adverse events were defined by a slit-lamp examination finding of grade 3 or worse; parental report of a clinically meaningful change (determined by the examiner) in eyes, vision, or health; or a clinically meaningful response (determined by examiner) to a symptom checklist. Adverse events were categorized and reported by examiners and finalized by the Executive Committee. The presence or absence of an infiltrate and a list of diagnoses was determined at the conclusion of the study.
The 294 participants wore their contact lenses 73.0 ± 26.5 hours per week, and 220 (74.8%) encountered at least 1 adverse event. Of the 432 adverse events, 75.2% were ocular, and 24.8% were nonocular. Contact lens wear was probably or definitely related to 60.6% of the ocular and 2.8% of the nonocular adverse events. None of the ocular adverse events were serious or severe or caused permanent contact lens discontinuation. The corneal infiltrate incidence was 185 cases per 10,000 patient-years of wear (95% confidence interval, 110 to 294). The incidence of moderate ocular adverse events that were definitely or probably related to contact lens wear was 405 cases per 10,000 patient-years of wear (95% confidence interval, 286 to 557).
The adverse events experienced by 7- to 11-year-old myopic children rarely required meaningful treatment and never led to permanent discontinuation of contact lens wear or loss of best-corrected vision.
儿童在年龄较小的时候就开始佩戴软性隐形眼镜来控制近视。这项针对 7 至 11 岁参与者佩戴软性隐形眼镜相关不良事件的 3 年调查，有助于验光师了解为儿童配软性隐形眼镜时可能会出现哪些情况。
本文旨在报告与儿童软性隐形眼镜佩戴相关的眼部和非眼部不良事件的频率和类型。
7 至 11 岁的儿童佩戴软性隐形眼镜 3 年。不良事件的定义是通过裂隙灯检查发现 3 级或更高级别的病变；父母报告眼睛、视力或健康有临床意义的变化（由检查者确定）；或对症状检查表有临床意义的反应（由检查者确定）。不良事件由检查者进行分类和报告，并由执行委员会最终确定。在研究结束时确定是否存在浸润以及列出诊断。
294 名参与者每周佩戴隐形眼镜 73.0±26.5 小时，220 名（74.8%）至少出现 1 次不良事件。432 次不良事件中，75.2%为眼部，24.8%为非眼部。软性隐形眼镜佩戴可能或肯定与 60.6%的眼部和 2.8%的非眼部不良事件有关。所有眼部不良事件均不严重或严重，也不会导致永久性隐形眼镜停止佩戴。角膜浸润的发生率为每 10000 患者佩戴年 185 例（95%置信区间，110 至 294）。与软性隐形眼镜佩戴肯定或可能相关的中度眼部不良事件的发生率为每 10000 患者佩戴年 405 例（95%置信区间，286 至 557）。
7 至 11 岁近视儿童经历的不良事件很少需要有意义的治疗，也从未导致软性隐形眼镜佩戴永久性停止或最佳矫正视力丧失。
