Prospects for contact lens wear in aphakia

Abstract

The success rate and complications for contact lens wear in 366 aphakic patients were evaluated retrospectively over a mean follow-up period of 36 months. Successful use of a daily wear contact lens (DWCL) was related to lens handling ability. In unilateral aphakia it was 86 per cent (161/187) for patients under 70 years old but only 27 per cent (19/70) for those over 70 years (p = <0.0001). This age related difference did not occur either for the use of a second lens, following successful use of a lens after the first cataract extraction, for which the overall success rate was 89 per cent (55/62) or for simultaneous bilateral lens fitting, which had a success rate of 81 per cent (38/47). Extended wear soft contact lenses (EWSCL) were fitted to patients unable to use DWCLs but only half were successful (21/40). There was no difference in the incidence of complications between daily wear soft and daily wear hard contact lenses or young (up to 44 years), middle aged (45-69 years) and elderly (over 70 years) patients, for the use of all DWCLs. However the risk of a serious complication was six times greater for patients using EWSCL (55 per cent) compared with those using DWCLs (8.8 per cent). DWCLs are a safe and successful method of aphakia correction for patients under 70 years of age. Once the ability to handle a DWCL has been learned, success is maintained when the second eye is fitted. EWSCLs have a high complication rate and a low success rate in patients unable to use DWCLs; other methods of aphakia correction should be considered first in this group.

References

  1. 1

    Graham CM, Dart JKG, Buckley RJ : Extended wear hydrogel and daily wear hard contact lenses for aphakia. Success and complications compared in a longitudinal study. Ophthalmology 1986, 93: 1489–94.

  2. 2

    Astin C : Aphakia contact lens fitting in a hospital department. J Br Contact Lens Assoc 1984, 7: 164–8.

  3. 3

    Astin C : Review of the 2nd year of the aphakic clinic at Moorfields Eye Hospital contact lens department. J Br Contact Lens Assoc 1986, 9 (Suppl): 14–8.

  4. 3b

    Miettinen OS : Simple interval estimation of risk ratio. Am J Epidemiol 1974, 100: 515–6.

  5. 5

    Apple DJ, Mamalis N, Loftfield K, Googe JM, Novak LC, Kavka-Van Norman D, Brady SE, Olson RJ : Complications of intraocular lenses. A historical and histopathological review. Surv Ophthalmol 1984, 29: 1–54.

  6. b5

    Liesegang TJ, Bourne WM, Ilstrup DM : Short- and long-term endothelial cell loss associated with cataract extraction and intraocular lens implantation. Am J Ophthalmol 1984, 97: 32–9.

  7. 7

    Oxford Cataract Treatment and Evaluation Team (OCTET): Long-term corneal endothelial cell loss after cataract surgery. Results of a randomised controlled trial. Arch Ophthalmol 1986, 104: 1170–5.

  8. 8

    Miyake K, Akasura M, Kobayashi H : Effect of intraocular lens fixation on the blood-aqueous barrier. Am J Ophthalmol 1984, 98: 451–5.

  9. 9

    Mondino BJ, Nagata S, Glovsky MM : Activation of the alternative complement pathway by intraocular lenses. Invest Ophthalmol Vis Sci 1985, 26: 905–8.

  10. 10

    Holden BA, Sweeney DF, Vannas A, Nilsson KT, Efron N : Effects of long-term extended contact lens wear on the human cornea. Invest Ophthalmol Vis Sci 1985, 26: 1489–501.

  11. 11

    Mac Rae SM, Matsuda M, Shellans S, Rich LF : The effects of hard and soft contact lenses on the corneal endothelium. Am J Ophthalmol 1986, 102: 50–7.

  12. 12

    Percival SPB and Yousef KM : Treatment of uniocular aphakia. A comparison of iris clip lenses with hard corneal contact lenses. Br J Ophthalmol 1976, 60: 642–4.

  13. 13

    Kersley HJ, Kerr C, Pierse D : Hydrophilic lenses for 'continuous' wear in aphakia: definitive fitting and the problems that occur. Br J Ophthalmol 1977, 61: 38–42.

  14. 14

    Martin NF, Kracher GP, Stark WJ, Maumenee AE : Extended-wear soft contact lenses for aphakic correction. Arch Ophthalmol 1983, 101: 39–41.

  15. 15

    Bernth-Petersen P and Sørensen T : Intraocular lenses versus extended-wear contact lenses in aphakic rehabilitation. A controlled clinical study. Acta Ophthalmol 1983, 61: 381–91.

  16. 16

    Oxford Cataract Treatment and Evaluation Team (OCTET): I. Cataract surgery: interim results and complications of a randomised controlled trial. Br J Ophthalmol 1986, 70: 402–10.

  17. 17

    Oxford Cataract Treatment and Evaluation Team (OCTET). II. Use of a grading system in the evaluation of complications in a randomised controlled trial on cataract surgery. Br J Ophthalmol 1986, 70: 411–4.

Download references

Author information

Affiliations

Authors

Corresponding authors

Correspondence to C M Graham or J K G Dart.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Graham, C., Dart, J., Wilson-Holt, N. et al. Prospects for contact lens wear in aphakia. Eye 2, 48–55 (1988). https://doi.org/10.1038/eye.1988.12

Download citation

Further reading