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The infant aphakia treatment study contact lens experience: one-year outcomes
Buddy Russell1, Michael A Ward, Michael Lynn
1Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA 30322, USA. buddy.russell@emoryhealthcare.org
Insights
Infants with unilateral aphakia successfully wore silicone elastomer (SE) or rigid gas permeable (RGP) contact lenses. Visual acuity outcomes were similar for both contact lens types, though RGP lenses required more frequent replacement.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Contact Lens Technology
Background:
- Unilateral aphakia in infants presents a significant challenge for visual development.
- Early visual rehabilitation is crucial to prevent amblyopia.
- Contact lenses are a primary method for correcting aphakia in infants.
Purpose of the Study:
- To evaluate the success and outcomes of contact lens wear in infants with unilateral aphakia.
- To compare the performance of silicone elastomer (SE) and rigid gas permeable (RGP) contact lenses in this population.
Main Methods:
- A cohort of 57 infants (1-6 months) were randomized to wear contact lenses.
- Examinations under anesthesia were conducted at enrollment and 1 year of age.
- Visual acuity was assessed by a traveling examiner at approximately 1 year of age.
Main Results:
- 74% of infants were fitted with SE lenses, 21% with RGP lenses.
- Median visual acuity was +0.80 logMAR for both lens types.
- SE lenses required fewer replacements (mean 10.9) than RGP lenses (mean 16.8).
- Mean keratometric power decreased slightly, and keratometric astigmatism showed a small reduction over 1 year.
Conclusions:
- Contact lenses are a safe and effective option for infants with unilateral aphakia.
- Visual acuity outcomes are comparable between SE and RGP contact lenses.
- SE contact lenses demonstrate a lower replacement frequency compared to RGP lenses in this infant cohort.
Purpose:
We describe our experience correcting a cohort of infants with contact lenses in the Infant Aphakia Treatment Study.
Materials And Methods:
Fifty-seven infants 1-6 months of age were randomized to contact lens wear. An examination under anesthesia was performed at the time of enrollment and at approximately 1 year of age. A traveling examiner assessed visual acuity at approximately 1 year of age.
Results:
Forty-two treated eyes (74 %) were fitted with silicone elastomer (SE) contact lenses; 12 eyes (21 %) with rigid gas permeable (RGP) contact lenses, and 3 eyes (5%) wore both lens types. Median visual acuity was +0.80 logMAR in both lens type-wearing groups. The mean (± SD) keratometric power of the treated eyes was 46.3±2.8 D at baseline and 44.6±2.3 D at 1 year of age for a mean decrease of 0.2±0.2 D/mo. Keratometric astigmatism of treated eyes was 1.98±1.37 D at baseline and 1.62±0.98 D at 1 year of age for a mean decrease of 0.05±0.2 D/mo. The mean RGP lens base curve at baseline was 47.62 D±2.62 D versus 47.00 D±3.50 D at 12 months after surgery. Children wearing SE lenses required a mean of 10.9 replacements (range 2-24) compared to 16.8 replacements (range 8-32) for children wearing RGP lenses. Three adverse events occurred.
Conclusions:
Contact lenses were worn successfully with relatively few adverse events by a cohort of infants with unilateral aphakia. The visual acuity results were identical independent of the contact lens material or modality. RGP lenses needed replacement more often than SE lenses.
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