Profile of pediatric aphakics over 10 years in a tertiary eye care - A retrospective study

To investigate the outcome of contact lens (CL) fitting in aphakic children following lensectomy for congenital cataract.

Retrospective data of 205 aphakic children who visited for CL fitting following lensectomy from 2008 to 2018 were collected. Data includes the demographic details, CL parameters in first and last visit, hours of CL wear, reason for discontinuation of CL, surgical procedures underwent and years of follow up.

205 (148 unilateral and 57 bilateral) aphakic children comprised of age group, < 1 month (n = 48), 1-3 months (n = 37), 3-6 months (n = 68), 6-12 months (n = 10), >12 months (n = 42). 173/205(84.39%) children were fitted with rigid gas permeable (RGP) and 32/205(15.6%) were fitted with soft CL at their first visit. 10 children had shifted to soft CL in their follow-up visits due to intolerance to RGP. 97/205(47.32%) children continued CL (55RGP, 42SCL) till the last follow-up for 2.17 ± 2.36 years and wore lens for 3.7 ± 3.65 h per day. Number of lenses replaced was 2 lenses (median) and maximum of 9 lenses over a period of 1-8 visits. The maximum visual acuity achieved was up to 0.2 log Mar units at the youngest age of 4 years on successful CL wear. 60/205(29.26%) children discontinued lenses at different follow-up visits due to IOL implantation(n = 28),using spectacles due to handling difficulty, child uncooperative to lens wear and lens fitting issues(n = 32). 48/205(23.41%) were lost to follow-up after the first visit. The average K (7.46 ± 0.43 mm) showed significant correlation to lens base curve in first visit (7.48 ± 0.41 mm) whereas flat K (7.71 ± 0.38 mm) showed significant correlation in the last visit (7.46 ± 0.39 mm) (p < 0.005). This was well described by a significant diameter change of 8.68 ± 0.31 mm to 9.42 ± 1.77 mm (p < 0.005) at the first and last visit respectively. The refractive error showed a significant difference between first (27.96 ± 5.33D) and last visit (21.97 ± 6.85D) (p < 0.005).

This study witnessed successful contact lens wear in only half of the children. The visual rehabilitation following lensectomy depends on right CL choice and close follow-up.