Improved Vision and Contact Lens Wear Time With Piggy-Back Contact Lens Systems in Children After Penetrating Corneal Trauma

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. Conclusion: 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.