Rigid Gas Permeable Contact Lens Management of Infantile Aphakia Status-Post Cataract Extraction

Abstract

Infants born with congenital cataracts require cataract extraction to prevent lifelong visual impairment resulting from deprivational amblyopia. After lensectomy, two optimal corrective treatment options exist: intraocular lens implantation or contact lens correction. This case presentation describes the etiology, treatment, and successful management of a patient with unilateral infantile aphakia with a rigid contact lens. The seven-week-old patient with a congenital cataract of the right eye was referred to our clinic for a contact lens fitting prior to cataract extraction. Surgeons often do not elect to manage aphakia with artificial lens implantation because the correct intraocular lens parameter is difficult to infer in a rapidly growing child, and surgical complications may occur. While glasses are important for when contact lens wear is not indicated, the high prescription required by these aphakic individuals results in significant visual distortion and aniseikonia. Contact lens correction has shown to be a safe and visually effective alternative to treating infantile aphakes. Various material options exist, including rigid gas permeable and soft lenses. While soft hydrogel lenses may appear more comfortable and less intimidating to a parent, limitations exist including restricted parameter availability for commercially produced lenses and reduced oxygen permeability for custom soft lenses. Rigid contact lenses provide optimal visual correction due to their extensive customizability while also offering high oxygen permeability. This lens modality, in conjunction with proper follow-up monitoring and ophthalmological co-management, provided for successful aphakia treatment in our patient. <br>CE Notification: This article is available as a COPE accredited CE course. You may take this course for 1-hour credit. Read the article and take the qualifying test to earn your credit. Click here to Enroll. (https://www.crojournal.com) Please check COPE course expiry date prior to enrollment. The COPE course test must be taken before the course expiry date.