Rigid Corneal Lenses for Visual Rehabilitation in Infants With Unilateral Aphakia After Cataract Surgery: A Longitudinal Case Series.

Abstract

Objectives: This study investigated the safety of rigid corneal lenses in children with unilateral aphakia after cataract surgery and observed the visual rehabilitation longitudinally.

Methods: This retrospective cohort study performed a 3-year follow-up of 21 infants (age 5.9±3.3 months) with unilateral congenital cataracts who started wearing rigid corneal contact lenses after cataract surgery. The basic presurgical patient information included chief complaint, intraocular pressure (IOP), axial length, corneal width, anterior segment, and fundus examination. The postsurgical visual acuity, IOP, and anterior segment were examined during regular postoperative follow-up visits. Keratometry was performed when contact lenses had to be changed.

Results: Of the 21 patients, 15 were male and 6 were female. Before surgery, the affected and nonaffected eyes had similar IOP (9.5±3.5 vs. 9.2±2.8 mm Hg; P=0.502) and axial length (19.2±1.5 vs. 19.4±0.96; P=0.333). The corneal diameter in the affected eyes was smaller than in the nonaffected eyes (10.2±0.7 vs. 10.6±0.6 mm; P=0.002). After surgery, the logarithm of the minimum angle of resolution vision of the affected eyes improved gradually, showing values of 1.12±0.28, 0.78±0.37, and 0.62±0.38 at 1, 2, and 3 years after surgery, respectively. The respective values in the unaffected eyes were 0.58±0.14, 0.40±0.13, and 0.33±0.16. The mean keratometric astigmatism and keratometry 1 and 3 years after surgery were statistically similar (2.09±1.21 vs. 1.73±1.16 D, P=0.272; 44.82±3.15 vs. 44.39±2.75 D, P=0.324, respectively). No serious complications occurred during the follow-up.

Conclusion: The rigid corneal lens is well tolerated and safe in aphakic eyes and can effectively improve children's visual acuity after unilateral cataract surgery. For patients able to receive rigid corneal lenses, intraocular lens implantation can be delayed until after the age of three.