Soft contact lens options in the management of pediatric aphakia – A quantitative and qualitative assessment

• Published in: Contact lens & anterior eye 2023-10, Vol.46 (5), p.101874-101874, Article 101874
• Main Authors: Shaikh, Noreen, Stec, Magdalena, Bohnsack, Brenda L.
• Format: Article
• Language: English
• Subjects: Aphakia; Congenital cataract; Contact lens; Flexlens Definitive; Silsoft SuperPlus
• ISSN: 1367-0484; 1476-5411
• DOI: 10.1016/j.clae.2023.101874

The main contact lens for pediatric aphakia has historically been a silicone elastomer lens (Silsoft SuperPlus). Due to supply chain disruption, many aphakic children required an alternative lens. We performed quantitative and qualitative comparisons between Silsoft SuperPlus and alternative aphakic soft contacts. Sixty-nine aphakic eyes of 49 patients wearing Silsoft SuperPlus lenses underwent the refitting process into an alternative soft contact. Data collected included lens parameters, visual acuity, keratometry, horizontal visible iris diameter, and over-refraction. A 6-question survey assessing the patients’/guardians’ experience with Silsoft SuperPlus versus the alternative lens was conducted at initial fit and 1–3 months post-fit. Twenty-four patients (49 %), 4(8 %), and 1(2 %) were refit into Flexlens Definitive 74, Biofinity XR, and Intelliwave Pro Toric lenses, respectively. Sixteen patients (34 %) remained in Silsoft SuperPlus due to personal lens surplus or inability to handle the new lens while 2(4 %) opted for glasses. Silsoft SuperPlus was typically successful in eyes with average keratometry (AveK) 7.4–7.6 mm. Flexlens Definitive 74 required a base curve 0.4 mm steeper than the AveK. Patients’/guardias' reported a trend toward greater comfort with handling Silsoft SuperPlus, however, patients experienced less adverse side effects with the alternative soft contact lenses. Flexlens Definitive 74 was an adequate alternative to Silsoft SuperPlus in aphakic children, however lens parameters must be steepened. Keratometry streamlined the contact lens fitting process. Alternative soft lenses are a cost-effective alternative to Silsoft contact lenses.