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Rigid gas permeable contact lens correction for young children with special refractive errors
Mingrui Jin1, Lizhou Liu2, Xuejing Mi1
1Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, China.
Insights
Rigid gas permeable (RGP) contact lenses significantly improve vision in young children with complex refractive errors. While effective for conditions like high myopia and astigmatism, outcomes were limited in children with coexisting ocular issues.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Visual Science
Background:
- Special refractive errors in young children often pose challenges for spectacle correction.
- Rigid gas permeable (RGP) contact lenses offer a viable alternative for managing these complex visual conditions.
- Early intervention with RGP lenses supports crucial visual development in children under six.
Purpose of the Study:
- To evaluate the visual outcomes of young children (under 6 years) with special refractive errors treated with RGP contact lenses.
- To assess the impact of RGP lens wear on best-corrected visual acuity (BCVA) and binocular function.
- To compare outcomes based on the type of refractive error and the presence of coexisting ocular conditions.
Main Methods:
- A retrospective study of 50 young children fitted with RGP lenses.
- Inclusion criteria: ultra-high hyperopia, myopia (≤-9.00D), high astigmatism (≥2.00D), high anisometropia (≥3.00D), with or without ocular lesions.
- Analysis of BCVA changes and binocular function (Worth 4-dot test, stereoacuity) before and after RGP wear (≥6 months).
Main Results:
- Significant BCVA improvement from 1.10 to 0.30 logMAR (p < 0.001) after RGP wear.
- 56% of children achieved BCVA of 6/12 or better; 17 demonstrated good binocular function.
- Highest rates of good binocular function were observed in ultra-high myopia (50%), high astigmatism (67%), and pure high anisometropia (50%).
Conclusions:
- RGP contact lenses are effective in significantly improving BCVA for young children with special refractive errors.
- Children with refractive errors alone showed the best outcomes with RGP lens wear.
- While RGP lenses provided some visual improvement in children with ocular lesions, binocular function remained limited in these cases.
Clinical Relevance:
Rigid gas permeable (RGP) contact lenses effectively correct special refractive errors in young children when spectacles fail, supporting visual development.
Background:
To analyse the visual outcomes of young children (under 6 years) with special refractive errors corrected using RGP contact lenses during the visual development.
Methods:
This retrospective study included 50 young children fitted with RGP lenses at Beijing Tongren Eye Centre (2019-2024). Special refractive errors included ultra-high hyperopia due to aphakia, ultra-high myopia (spherical equivalent≤-9.00D), high astigmatism (astigmatism ≥2.00D), and high anisometropia (interocular difference ≥3.00D). Some anisometropia cases had coexisting ocular lesions (myelinated retinal nerve fibres, familial exudative vitreoretinopathy, persistent pupillary membrane). All children were > 4.5 years at final visit with ≥6 months RGP wear. We compared the changes in best-corrected visual acuity (BCVA) before and after RGP contact lens wear in these children and analysed their final visual outcomes. Binocular function was considered 'good' if the Worth 4-dot test showed fusion at near and far distances, with stereoacuity ≤100 seconds of arc.
Results:
Median age at RGP initiation was 3.16 years (interquartile range (IQR) 2,4), with a median wear duration of 2 years (IQR 1,3.17). BCVA improved significantly from 1.10 logMAR (IQR 1.23,1.01) to 0.30 logMAR (IQR 0.50,0.10) (p < 0.001). A total of 28 patients (56%) achieved a BCVA of 6/12 or better, with 17 showing good binocular function. The highest binocular function rates were in groups with ultra-high myopia (50%), high astigmatism (67%), and pure high anisometropia (50%). None of the nine patients with coexisting ocular lesions achieved good binocular function.
Conclusions:
RGP lenses significantly improve BCVA in young children with special refractive errors. The best results were observed in cases of refractive errors alone, while those with other ocular lesions showed limited but notable improvements from baseline.
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