Abstract
Purpose: :
To describe the follow-up of fitting with hyper oxygen-permeable rigid contact lens for aphakic infant eyes after surgery of congenital cataract and to estimate the functional results.
Methods: :
This retrospective study was performed on 23 eyes of 17 children (12 boys and 5 girls) operated for cataract extraction without primary intraocular lens implantation and adapted exclusively with lens Menicon ® Z material. The initial consultation of fitting included information and family’s education. The following examinations were performed at 8 days, 15 days, 1 month, 6 months and 1 year. The four main evaluations were fit characteristics, manipulation, eye integrity and lens integrity. At the same time, functional results (visual acuity, binocular vision) and factors influencing the prognosis (associated pathology, age at surgery, stage of cataract development , uni or bilateral cases, postoperative complications) were estimated. A systematic strict amblyopia rehabilitation was made.
Results: :
After one year follow-up, the hyper oxygen-permeable rigid contact lens fitting managed by the same expert contactologist, showed an easy manipulation by parents (60 % of parents know how to manipulate after 1 month, 3 cases of failure by difficulties of manipulation). The examination revealed a good eye integrity (1 case of failure by infectious complication). Material characteristics proved its resistance (lens broken in 9 % of cases after 1 month) and its integrity (absence of deposits in 95 % of cases after 1 month). About visual outcome, in children population old enough to cooperate, visual acuity measure was more than 3/10 ° for 9 eyes on 12, among 5 eyes with 10/10 °. We find 12 cases of strabismus (70,6%) after surgery (10 esotropia, 2 exotropia). The predictive factors of good visual acuity corresponded with the literature: partial cataract, bilateral cataract, and no oculomotor disorder.
Conclusions: :
The characteristics of hyper oxygen-permeable rigid contact lens provided safety and efficacity in aphakic infant eyes. It seems to be an interesting alternative in primary intraocular lens implantation in congenital cataract.
Keywords: contact lens • cataract