Soft contact lens options in the management of pediatric aphakia - A quantitative and qualitative assessment
Noreen Shaikh1, Magdalena Stec2, Brenda L Bohnsack2
1Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, USA.
Insights
Alternative soft contact lenses provide a viable option for pediatric aphakia management when Silsoft SuperPlus lenses are unavailable. These lenses offer comparable outcomes with fewer adverse effects, though fitting parameters require adjustment.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Contact Lens Technology
Background:
- The primary contact lens for pediatric aphakia, Silsoft SuperPlus, faced supply chain disruptions.
- This necessitated the evaluation of alternative aphakic soft contact lenses for pediatric patients.
Purpose of the Study:
- To quantitatively and qualitatively compare Silsoft SuperPlus with alternative soft contact lenses for pediatric aphakia.
- To assess the suitability and patient experience with alternative lenses.
Main Methods:
- Refitting 69 aphakic eyes from Silsoft SuperPlus to alternative soft lenses (Flexlens Definitive 74, Biofinity XR, Intelliwave Pro Toric).
- Collecting data on lens parameters, visual acuity, keratometry, and patient/guardian feedback via surveys.
- Comparing outcomes and experiences between Silsoft SuperPlus and alternative lenses at initial fit and 1-3 months post-fit.
Main Results:
- 49% of patients were refit into Flexlens Definitive 74, with others into Biofinity XR or Intelliwave Pro Toric.
- Silsoft SuperPlus was successful with average keratometry (AveK) of 7.4-7.6 mm; Flexlens Definitive 74 required a 0.4 mm steeper base curve.
- Patients reported greater comfort with Silsoft SuperPlus handling but fewer adverse side effects with alternative soft lenses.
Conclusions:
- Flexlens Definitive 74 is an adequate alternative for aphakic children, requiring steeper lens parameters.
- Keratometry aids in streamlining the contact lens fitting process for aphakic patients.
- Alternative soft contact lenses present a cost-effective option compared to Silsoft contact lenses.
Background:
The main contact lens for pediatric aphakia has historically been a silicone elastomer lens (Silsoft SuperPlus). Due to supply chain disruption, many aphakic children required an alternative lens. We performed quantitative and qualitative comparisons between Silsoft SuperPlus and alternative aphakic soft contacts.
Method:
Sixty-nine aphakic eyes of 49 patients wearing Silsoft SuperPlus lenses underwent the refitting process into an alternative soft contact. Data collected included lens parameters, visual acuity, keratometry, horizontal visible iris diameter, and over-refraction. A 6-question survey assessing the patients'/guardians' experience with Silsoft SuperPlus versus the alternative lens was conducted at initial fit and 1-3 months post-fit.
Results:
Twenty-four patients (49 %), 4(8 %), and 1(2 %) were refit into Flexlens Definitive 74, Biofinity XR, and Intelliwave Pro Toric lenses, respectively. Sixteen patients (34 %) remained in Silsoft SuperPlus due to personal lens surplus or inability to handle the new lens while 2(4 %) opted for glasses. Silsoft SuperPlus was typically successful in eyes with average keratometry (AveK) 7.4-7.6 mm. Flexlens Definitive 74 required a base curve 0.4 mm steeper than the AveK. Patients'/guardias' reported a trend toward greater comfort with handling Silsoft SuperPlus, however, patients experienced less adverse side effects with the alternative soft contact lenses.
Conclusions:
Flexlens Definitive 74 was an adequate alternative to Silsoft SuperPlus in aphakic children, however lens parameters must be steepened. Keratometry streamlined the contact lens fitting process. Alternative soft lenses are a cost-effective alternative to Silsoft contact lenses.
