Long-term results of early contact lens use in pediatric unilateral aphakia.
OBJECTIVE
To evaluate which factor(s) might predict excellent Snellen visual acuity results in unilateral nontraumatic pediatric aphakes.


METHODS
Retrospective review of all unilateral pediatric aphakic patients seen in a specialty contact lens clinic between 1982 and 2009. Inclusion criteria as follows: (1) cataract extraction before age 6 weeks, (2) no other health complications, (3) contact lens fitting within 3 weeks postsurgery, and (4) measurable subjective visual performance on a clinical Snellen acuity chart. Fifteen patients were identified: 10 patients with persistent fetal vasculature syndrome (PFV) and 5 patients with the diagnosis of idiopathic congenital cataract (ICC).


RESULTS
Final Snellen acuity results showed seven patients (46.67%) developed excellent Snellen visual acuities (defined as 20/50 or better), four patients (26.67%) developed moderate Snellen visual acuities (20/125 to 20/60), and four total patients (26.67%) developed poor Snellen visual acuities (worse than 20/200). Analysis used descriptive statistics.


CONCLUSIONS
Approximately 50% of our unilateral nontraumatic pediatric aphakic patients aged older than 5 years achieved excellent Snellen visual acuity in the aphakic eye. The amount of surgical or ocular complications seems to have an inverse relationship with Snellen visual acuity in PFV. Patching compliance, without implying cause-effect direction, also had a direct relationship with final Snellen visual acuity for patients. Early cataract extraction, good to moderate patching compliance, and aggressive early contact lens management can lead to moderate to excellent Snellen visual results in several unilateral pediatric aphakic patients.
Chen
Ying-Chun Ellin
YC
Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at University of California at Los Angeles, CA, USA. ellinchen@gmail.com
Hu
Annie C
AC
Rosenbaum
Arthur
A
Spooner
Sharon
S
Weissman
Barry A
BA
D000293:Adolescent; D001035:Aphakia / Q000534:rehabilitation*; D001036:Aphakia, Postcataract / Q000534:rehabilitation*; D002386:Cataract / Q000151:congenital; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D003262:Contact Lenses, Extended-Wear / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity