Prospects for contact lens wear in aphakia.
The success rate and complications for contact lens wear in 366 aphakic patients were evaluated retrospectively over a mean follow-up period of 36 months. Successful use of a daily wear contact lens (DWCL) was related to lens handling ability. In unilateral aphakia it was 86 per cent (161/187) for patients under 70 years old but only 27 per cent (19/70) for those over 70 years (p = less than 0.0001). This age related difference did not occur either for the use of a second lens, following successful use of a lens after the first cataract extraction, for which the overall success rate was 89 per cent (55/62) or for simultaneous bilateral lens fitting, which had a success rate of 81 per cent (38/47). Extended wear soft contact lenses (EWSCL) were fitted to patients unable to use DWCLs but only half were successful (21/40). There was no difference in the incidence of complications between daily wear soft and daily wear hard contact lenses or young (up to 44 years), middle aged (45-69 years) and elderly (over 70 years) patients, for the use of all DWCLs. However the risk of a serious complication was six times greater for patients using EWSCL (55 per cent) compared with those using DWCLs (8.8 per cent). DWCLs are a safe and successful method of aphakia correction for patients under 70 years of age. Once the ability to handle a DWCL has been learned, success is maintained when the second eye is fitted. EWSCLs have a high complication rate and a low success rate in patients unable to use DWCLs; other methods of aphakia correction should be considered first in this group.
Graham
C M
CM
Contact Lens and Prosthesis Department, Moorfields Eye Hospital, London.
Dart
J K
JK
Wilson-Holt
N W
NW
Buckley
R J
RJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001036:Aphakia, Postcataract / Q000628:therapy*; D003261:Contact Lenses / Q000009:adverse effects; D003262:Contact Lenses, Extended-Wear; D006801:Humans; D007634:Keratitis / Q000209:etiology; D008875:Middle Aged