title: Improved Vision and Contact Lens Wear Time With Piggy-Back Contact Lens Systems in Children After Penetrating Corneal Trauma.
abstract: OBJECTIVE
  Consecutive case series of children treated successfully with "piggy-back" (PB) contact lens systems after corneal trauma.
  
  
  METHODS
  We reviewed the medical record of all children ages 4 to 14 years treated at the Emory Eye Center between January 11, 2003 and January 11, 2013 with PB contact lens systems.
  
  
  RESULTS
  Four children with a history of corneal penetrating trauma were treated with a PB lens system, with a mean age of 7±0.08 (range: 6-8) years. Best-corrected spectacle vision was count fingers in two children and logMAR +0.70 (Snellen equivalent 20/100) and logMAR +0.6 (Snellen equivalent 20/80) in the remaining two. The PB lens system was introduced with a mean of 15.7±6.5 (range: 9-22) months after the injury. All patients were initially fitted with gas-permeable (GP) lenses. Each child achieved 11 or more hours of daily contact lens wear time in PB systems. The mean best-corrected logMAR visual acuity using the PB system was 0.26±0.21 (Snellen equivalent 20/36). The mean improvement in best-corrected logMAR between GP and PB lens systems was +0.21±0.11, which corresponds to an improvement of greater than two lines on the Snellen chart.
  
  
  CONCLUSIONS
  Piggy-back contact lens systems can be helpful to improve vision and contact lens wearing time in children with irregular astigmatism after corneal trauma, who are intolerant of GP contact lenses.
authors.affiliation: Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Cromelin
authors.forename: Buddy
authors.initials: B
authors.lastname: Russell
authors.forename: Scott R
authors.initials: SR
authors.lastname: Lambert
mesh_terms: D002648:Child; D003261:Contact Lenses / Q000706:statistics & numerical data*; D065306:Corneal Injuries / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D015807:Eye Injuries, Penetrating / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D017755:Prosthesis Fitting; D012189:Retrospective Studies; D013997:Time Factors; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology*