Contact lenses for the treatment of pediatric cataracts.
OBJECTIVE
To evaluate the experiences, attitudes, and perceptions of the caregivers of children with cataracts who were visually rehabilitated with contact lenses.


METHODS
One hundred twenty-three caregivers of children <8.1 years old treated for unilateral and bilateral cataracts at one pediatric hospital.


METHODS
Survey by questionnaire.


METHODS
Primary caregivers were asked to complete an anonymous questionnaire.


METHODS
Caregiver responses to questions assessing background and demographic and clinical information, as well as perceptions, attitudes, levels of compliance, and anxiety with respect to treatment, were reviewed. Caregivers were also asked to choose between aphakic rehabilitation with contact lenses, aphakic glasses, or intraocular lenses, given various hypothetical scenarios differing in regard to their final visual prognosis, risks of treatment complications, and cost.


RESULTS
The response rate was 82.9%. Absolute average stress levels for contact lens use were 1.36 +/- 1.79 and 0.79 +/- 1.48 (scale, 0-5) for insertion and removal, respectively, compared with 4.03 +/- 1.64 and 2.40 +/- 1.92 for cataract surgery and patching therapy, respectively. Although average paired initial resistance to treatment (RT) levels for contact lens insertion and removal on a scale of 0 to 3 were high (2.09 +/- 1.15) and moderate (1.63 +/- 1.20), respectively, final RT levels were significantly lower (1.09 +/- 1.14 and 0.66 +/- 1.07, respectively; P < 0.0001). The vast majority of caregivers chose contact lens use in hypothetical scenarios that depicted realistic expectations for other forms of aphakic rehabilitation.


CONCLUSIONS
In our study, contact lenses seemed to be well tolerated by most patients, as assessed by caregivers. Although initial resistance to contact lens use is high, this decreases with time. Relative to other events in the treatment of pediatric cataracts, contact lens use is not a major stressor for most caregivers and patients. This study supports the notion that contact lenses should continue to receive serious consideration as a treatment option for pediatric cataracts.
Ma
Joseph J K
JJ
Department of Ophthalmology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
Morad
Yair
Y
Mau
Elaine
E
Brent
Henry P
HP
Barclay
Robert
R
Levin
Alex V
AV
D001036:Aphakia, Postcataract / Q000150:complications / Q000628:therapy*; D001290:Attitude; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D003261:Contact Lenses / Q000191:economics / Q000706:statistics & numerical data*; D005139:Eyeglasses; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007910:Lenses, Intraocular; D008297:Male; D010349:Patient Compliance; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000209:etiology / Q000534:rehabilitation*; D014792:Visual Acuity