| ObjectiveTo compare correction efficacy of wearing rigid gas permeable contact lens(RGPCL)and frame glasses in the infants with aphakia after congenital cataract surgery.MethodsThe clinical data of 46 cases(72 eyes)of 3 to 12-month-old infants who were aphakia after congenital cataract surgery were collected from November 2015 to March 2018 in the Department of Ophthalmology in the First Affiliated Hospital of Zhengzhou University.A prospective study.According to the method of refractive correction patients were divided into two groups:group A,31 eyes of 20 infants,wore RGPCL and group B,41 eyes of 26 infants,wore frame glasses.Infants in group A wore RGPCL about 1 month after surgery,while infants in group B wore frame glasses about 1 week after surgery.Visual function training was performed in all cases after surgery.The follow-up time was 12 months.Specific items:preferential looking check corrected visual acuity,retinoscopy optometry check the diopter,A ultrasound for axial length,Hirschberg Test examines nystagmus and eye position,4~?prism bottom-out test and 15~?prism bottom-out test check binocular simultaneous vision,anterior segment and the integrity of the lens test using slit lamp microscope.Results1.The visual acuity of both groups were significantly improved at 12 months after surgery compared with that at 1 month after surgery(group A Z=-6.791,P=0.000;group B Z=-7.427,P=0.000);Compared with group B,the visual acuity of group A was significantly improved,and the difference was statistically significant(Z=-3.496,P=0.000).2.The rate of nystagmus before treatment of RGPCL was 55.0%(11/20)in group A,and the rate of nystagmus remission at the end of follow-up was 54.5%(6/11).The rate of nystagmus before treatment of frame glasses was 46.2%(12/26)in group B,and the rate of nystagmus remission at the end of follow-up was 25.0%(3/12).The eye position was improved compared with the beginng in both groups.3.At 12 months after surgery,5 cases(55.6%)in group A and 3 cases(21.4%)in group B established the binocular simultaneous vision at 15~?prism bottom-out test.The movement of Eye position of both groups was not detected in the 4~?prism bottom-out test.4.The diopter of the two groups decreased with age and tended to drift towards myopia,and the diopter changed faster in the first 6 months after surgery than in the last 6 months.There was no significant difference in diopter between the two groups.5.Comparison of changes in axial length preoperative and 12 months after surgery:preoperative axial lengths of two groups were 18.63±1.02mm and 18.42±1.21mm respectively;after 12 months of surgery,the axial length of two groups were 21.13±0.57mm and 20.99±0.61mm respectively.The postoperative axial length of the two groups was longer than that of the preoperative axial length,and the difference was statistically significant(group A t=-11.980,P=0.000;group B t=-12.082,P=0.000).There was no significant difference in axial length between the two groups at 12 months after surgrry.6.In group A,1 patient abandoned wearing RGPCL after 9 months due to cumbersome procedures and difficult lens care and 1 patient abandoned RGPCL after wearing it for 12 months;There was one conjunctival congestion case,but it disappeared after the treatment of antibiotic eye drops.No ocular complications related to visual acuity occurred in both groups.Conclusion1.RGPCL can steadily improve the vision of infants who are aphakia after congenital cataract surgery,and the effect is better than that of frame glasses.2.RGPCL is safe and effective to infants who are aphakia after congenital cataract surgery,which is conducive to the reconstruction of visual function.It is a scientific and effective optical correction method. |
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