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Long-term results of early contact lens use in pediatric unilateral aphakia
Ying-Chun Ellin Chen1, Annie C Hu, Arthur Rosenbaum
1Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at University of California at Los Angeles, CA, USA. ellinchen@gmail.com
Insights
Nearly half of pediatric aphakic patients achieved excellent vision after early cataract surgery and contact lens management. Factors like fewer complications and good patching compliance positively influenced visual outcomes in unilateral aphakia.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Visual Science
Background:
- Unilateral pediatric aphakia presents challenges in visual development.
- Early management is crucial for optimizing visual outcomes.
Purpose of the Study:
- To identify predictors of excellent Snellen visual acuity in unilateral nontraumatic pediatric aphakes.
- To analyze factors influencing visual outcomes in pediatric aphakia.
Main Methods:
- Retrospective review of unilateral pediatric aphakic patients (1982-2009).
- Inclusion criteria: early cataract extraction (<6 weeks), no major complications, timely contact lens fitting, and measurable visual acuity.
- Patients included those with persistent fetal vasculature syndrome (PFV) and idiopathic congenital cataract (ICC).
Main Results:
- 46.67% achieved excellent visual acuity (≥20/50).
- 26.67% achieved moderate visual acuity (20/125 to 20/60).
- 26.67% had poor visual acuity (<20/200).
Conclusions:
- ~50% of unilateral pediatric aphakes older than 5 years achieved excellent Snellen visual acuity.
- Fewer surgical/ocular complications correlated with better visual acuity in PFV.
- Patching compliance and early, aggressive contact lens management are associated with better visual outcomes.
Objectives:
To evaluate which factor(s) might predict excellent Snellen visual acuity results in unilateral nontraumatic pediatric aphakes.
Methods:
Retrospective review of all unilateral pediatric aphakic patients seen in a specialty contact lens clinic between 1982 and 2009. Inclusion criteria as follows: (1) cataract extraction before age 6 weeks, (2) no other health complications, (3) contact lens fitting within 3 weeks postsurgery, and (4) measurable subjective visual performance on a clinical Snellen acuity chart. Fifteen patients were identified: 10 patients with persistent fetal vasculature syndrome (PFV) and 5 patients with the diagnosis of idiopathic congenital cataract (ICC).
Results:
Final Snellen acuity results showed seven patients (46.67%) developed excellent Snellen visual acuities (defined as 20/50 or better), four patients (26.67%) developed moderate Snellen visual acuities (20/125 to 20/60), and four total patients (26.67%) developed poor Snellen visual acuities (worse than 20/200). Analysis used descriptive statistics.
Conclusions:
Approximately 50% of our unilateral nontraumatic pediatric aphakic patients aged older than 5 years achieved excellent Snellen visual acuity in the aphakic eye. The amount of surgical or ocular complications seems to have an inverse relationship with Snellen visual acuity in PFV. Patching compliance, without implying cause-effect direction, also had a direct relationship with final Snellen visual acuity for patients. Early cataract extraction, good to moderate patching compliance, and aggressive early contact lens management can lead to moderate to excellent Snellen visual results in several unilateral pediatric aphakic patients.
