Contact lenses in the correction of childhood aphakia

To evaluate the results of extended-wear silicone contact lenses (Silsoft, Bausch & Lomb, Rochester, NY, U.S.A) after congenital cataract extraction.

Case records of congenital cataract extraction performed between 1992-1999, in the Department of Ophthalmology, Dokuz Eylül University School of Medicine, were retrospectively reviewed. Convenient-power extended-wear silicone contact lenses (Silsoft) were prescribed for patients 5 to 12 days after surgery. Patients were scheduled for follow-up control visits once per month in the first year, bimonthly in the second year, and quarerly visits thereafter. Visual acuity, fixation, binocularity, and deviation were checked at each follow-up visit. Examination of the cornea and the contact lens surface was also performed at each visit.

A total of 51 children (83 eyes) were included in the study. Mean age was 19.4 +/- 18 months. Mean duration of contact lens wear per lens was 26 +/- 11 weeks. Contact lens wear was discontinued for 11 eyes: 6 because of unstable lens, frequent loss, and financial problems, and 5 were discontinued because of recurrent irritation and corneal infiltration. Mean contact lens usage time per patient was 5.8 years, and mean contact lens loss was 0.98 per year. Visual acuity improved in 58 (69.8%) eyes and remained unaltered in the remaining 25 eyes.

Extended-wear silicone contact lenses offer a safe, easy treatment option for childhood aphakia, providing prolonged wearing time and low rates of complications and drop out.