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Contact lenses in pediatrics study in Singapore
Lim Li1, Kurt Moody, Donald T H Tan
1Singapore National Eye Centre, Singapore. lim.li@snec.com.sg
Insights
Daily disposable soft contact lenses are safe and effective for children in Singapore, improving vision and comfort compared to spectacles. While some corneal staining occurred, it was generally mild and comparable to adult studies.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Contact Lens Research
Background:
- Previous contact lens (CL) studies in the US focused on older children and teens.
- The safety, efficacy, and performance of daily disposable soft CLs in younger children in Singapore remained unevaluated.
Purpose of the Study:
- To assess the safety, efficacy, and physiologic performance of daily disposable soft CLs in Singaporean children aged 8-11 years.
- To compare vision quality, comfort, and handling of CLs versus spectacles.
Main Methods:
- An open-label, 3-month study involving 59 pediatric subjects (neophytes) fitted with etafilcon A daily disposable soft CLs.
- Subjects underwent follow-up evaluations at 1 week, 1 month, and 3 months, including questionnaires for parents and children.
- Inclusion criteria: myopia up to -9.00D or hyperopia up to +6.00D with specified astigmatism.
Main Results:
- 90% of subjects successfully completed the study; 53 out of 59 children.
- CL wear resulted in significantly improved vision quality and comfort compared to spectacles.
- Increased limbal/bulbar hyperemia and corneal staining (21% at 3 months) were observed, but generally mild.
Conclusions:
- Daily disposable soft CLs are well-tolerated and effective for vision correction in Singaporean children.
- The observed corneal staining rate is lower than in adult studies but higher than in a previous US pediatric study.
Purpose:
Previous studies in the United States have evaluated the benefits of soft contact lenses (CLs) in 8- to 12-year-old children and 13- to 17-year-old teens. This study was undertaken in Singapore and evaluated the safety, efficacy, and physiologic performance of daily disposable soft lenses in a population of children.
Methods:
In this open-label, bilateral, 3-month dispensing study, 59 children (8-11 years) were fit with etafilcon A spherical or toric daily disposable lenses (1-DAY ACUVUE or 1-DAY ACUVUE for ASTIGMATISM, Vistakon, Jacksonville, FL). All subjects were neophytes requiring visual correction in both eyes. The refractive inclusion criteria were plano to -9.00 diopter (D) with astigmatism of < or =2.00DC in both eyes, or hyperopia of +0.50 to +6.00D with astigmatism of 0.75D or less. The subjects underwent follow-up evaluations, which included a questionnaire for parents and subjects, at 1 week, 1 month, and 3 months.
Results:
Of the 59 subjects enrolled, 53 (90%) completed the study successfully. Six subjects were discontinued because of lens handling difficulties (four), unacceptable lens fit (one), and an adverse event (one). Adverse events were reported in three subjects, including the discontinuation, and in each case were due to a chalazion. Overall vision quality, overall comfort, and end-of-day comfort were graded significantly better at each of the follow-up visits compared with baseline with spectacles (P< or =0.0001). Both handling and reported symptoms improved during the course of the study. The questionnaire results indicated that most of both parents and subjects preferred CLs to spectacles across a wide variety of aspects including vision, comfort, handling, and appearance. Significantly, more limbal and bulbar hyperemia was noted at follow-up visits than at baseline (P=0.0001); however, no instances of hyperemia greater than grade 2 were noted at any visit. Significantly, more corneal staining was also noted at the 1- and 3-month follow-up visits than at baseline (21% at 3 months).
Conclusion:
A high proportion of Singaporean children requiring vision correction are able to successfully wear daily disposable soft CLs over a 3-month period. Overall, slit lamp findings showed the prevalence of corneal staining in this study to be 21% at 3 months, which is lower than that previously reported in adults, but higher than that reported in the US Contact Lenses in Pediatrics study (6%).
