METHODS: This retrospective multicentre chart review included the files of aphakic CL wearers under the age of 9 years old that were treated between 2008 and 2018. Patients with traumatic aphakia and scarring of the cornea were excluded. The following data were collected; demographic data, cataract type (congenital or secondary), CL type, parameters and wearing time, reason for replacement and discontinuation of the CLs, visual acuity (VA), prophylactic use of antibiotics (ABs), and complications.
RESULTS: Ninety-one aphakic children (132 eyes) were fitted with soft CLs. The median age of cataract extraction was 10.50 weeks (interquartile range (IQR) 7,15) in the congenital cataract group and 112 weeks (IQR 41,285) in the secondary cataract group. At the initial fitting a silicone elastomer CL was fitted in 86 % and a silicone hydrogel CL in 12 %, the remaining 2 % were mixed CL types. The median CL power at baseline was + 29 D (IQR 25,32) and after 3 years of wear the median power had shifted significantly to + 20 D (IQR 17,26), P < 0.001. A total of 1083 extra CL replacements were needed of which 414 in the first year of wear. Of these 414 replacements almost half (46 %;n = 191) were due to loss of the CL. Complications developed in 8 (9 %) cases and 7 (8 %) patients discontinued CL wear.
CONCLUSIONS: This paper confirms that paediatric aphakia can be successfully treated with soft CLs with low rates of complications and discontinuation encountered. Unscheduled CL replacements due to loss are a concern, especially in the first year, and are straining for both the care giver and medical system. Attentive care and clear information is advised during the first year of CL wear.
方法:这项回顾性多中心图表审查包括2008年至2018年接受治疗的9岁以下无晶状体CL佩戴者的档案。排除外伤性无晶状体眼和角膜瘢痕形成的患者。收集了以下数据;人口统计数据,白内障类型(先天性或继发性),CL型,参数和佩戴时间,更换和终止CL的原因,视敏度(VA),预防性使用抗生素(ABs),和并发症。
结果:91名无晶状体儿童(132只眼)安装了柔软的CLs。先天性白内障组的白内障摘除中位年龄为10.50周(四分位距(IQR)7,15),继发性白内障组为112周(IQR41,285)。在初始拟合时,有机硅弹性体CL的拟合率为86%,有机硅水凝胶CL的拟合率为12%,其余2%为混合CL类型。基线时的中位CL功率为+29D(IQR25,32),磨损3年后,中位功率已显著移至+20D(IQR17,26)。P<0.001。总共需要1083次额外的CL更换,其中414次在磨损的第一年。在这414个替换中,几乎一半(46%;n=191)是由于CL的损失。8例(9%)患者出现并发症,7例(8%)患者停止了CL磨损。
结论:本文证实,小儿无晶状体眼可以成功地用软CLs治疗,并发症和停药率低。由于损失而导致的计划外CL更换是一个问题,尤其是在第一年,对护理人员和医疗系统都很紧张。在CL佩戴的第一年,建议细心的护理和明确的信息。