Visual acuity outcomes and complications for aphakic children managed with rigid gas permeable contact lens wear at Queensland Children's Hospital 2014 - 2021

Abstract

Purpose: To assess the visual acuity outcomes and complication rates of aphakic children who are managed with rigid gas permeable contact lenses following lensectomy. Method: A single centre retrospective chart review of all children undergoing lensectomy from 1 January 2014 to 1 January 2021. Cases were identified from theatre coding and electronic medical records. Results: One hundred and fifteen aphakic eyes were included, 79 were bilateral while 36 were unilateral. The average age at time of surgery was 26.8 months (range 4 weeks - 9 years). The average LogMAR pre-operative visual acuity, where recordable, was 0.67 (n = 24, interquartile range [IQR] 0.4-0.9) while the average post-operative acuity was 0.47 (n = 74, IQR 0.2-0.6). For bilateral cases the average post-operative acuity was 0.41 (n = 57, IQR 0.2-0.6) while unilateral cases had a visual acuity of 0.67 post-operatively (n = 17, IQR 0.4-1.2). The visual acuity was significantly better in the bilateral group compared to the unilateral group (p = 0.016). For children under six months undergoing lensectomy (n = 61), 25 unilateral and 36 bilateral. The average postoperative visual acuity was 0.55 (n = 29, IQR 0.3-0.7), 0.81 for unilateral (n = 9, IQR 0.5-1.2) and 0.45 (n = 19, IQR 0.25-0.6) for bilateral. The visual acuity for bilateral cases was again significantly better than unilateral cases (p = 0.026). Microbial keratitis occurred in 3.4% of patients (n = 4). Five children (4.3%) required secondary intraocular insertion due to contact lens intolerance. Conclusion: Visual acuity is better for aphakic children who have bilateral cataracts when managed with RGPs. The rate of microbial keratitis and secondary intraocular lens insertion is low.L6366695462021-12-27 <br />