CONTACT-LENS INTOLERANCE IN INFANTILE APH AKIA - INDICATION FOR INTRAOCULAR LENSES

Due to the low rate of complications, lentectomy and contact lens fitt ing is the standard treatment for congenital cataract. However, contac t lens fitting is not possible in all children. The authors report the main reasons for discontinuation of contact lenses in their patients. Method: In 134 consecutive lentectomies of 90 children, the underlyin g eye diseases and general diseases,the age at operation, compliance o f parents and children, and social background were analyzed. Results: Twenty of the 90 children had to discontinue contact lens wearing. Twe lve of these children were operated on one eye and 8 on both eyes. Onl y 2 children showed signs of contact lens complications. In 2 children treatment was stopped because of the poor visual prognosis and in 10 children the parents discontinued contact lens treatment because of a severe handicap of the child (n = 2) or due to misunderstanding and pa rental noncompliance (n = 8). Six children refused contact lenses wit hout obvious reasons. Among the latter, children 2-4 years of age were at the greatest risk. Children with additional systemic abnormalities frequently developed contact lens intolerance. Conclusion: In childre n with systemic abnormalities and in the case of parental communicatio n and compliance problems, discontinuation of contact lenses has to be expected in up to 30 % of cases. In these children and in children wh o object to contact lenses at the age of 2-4 years, intraocular lens i mplantation should be considered, especially in unilateral cataract, i f successful contact lens treatment is not achievable within 8-12 week s.