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Anja Gruenert, Michael Klueppel, Juergen Hausser, Thomas Reinhard, Rainer Sundmacher, Tanja Guthoff, Thomas Fuchsluger, Gerd Geerling; Correction of infant aphakia after cataract surgery with rigid gas-permeable contact lenses. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5474.
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To evaluate the visual outcome of aphakic infants treated with rigid gas permeable contact lenses following surgery of congenital cataract. Furthermore to investigate the safety and viability of rigid contact lens correction in children.
We performed a retrospective analysis of infants who underwent cataract surgery and were subsequently treated with rigid gas permeable contact lenses between 1987 and 2011 (n=75). The infants were divided into four prognostic groups: bilateral aphakia (Group I), monolateral aphakia with early (Group II) or late (Group III) surgery and aphakia with additional ocular pathologies (Group IV). The outcome was evaluated in terms of visual acuity, refractive power, keratometric astigmatism, compliance with the wear of the lenses and development of strabism.
The toleration of rigid contact lenses was extremely well. After a short training period most parents didn’t have any difficulties in manipulating the lens. The visual outcome was dependent on monolateral or bilateral cases, the age at the time of surgery and additional pathologies. Infants with aphakia on both sides (Group I) achieved visual acuities up to 1.0, whereas in monolateral cases development of amblyopia was frequent. The functional results were better with early cataract surgery (Group II) than with late surgery (Group III). In Group IV the prognosis was very limited due to further pathologies. As hyperopia decreases during infancy the power of rigid contact lenses had to be adjusted frequently.
To our knowledge, at this time this is the largest group of patients analysed. Rigid gas-permeable contact lenses are very efficient in improving visual outcome of aphakic children. Provided a good compliance and collaboration with the parents, rigid gas permeable contact lenses represent a preferential alternative to intraocular lens implantation after extraction of congenital cataract.
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