Purpose

To review the published literature to assess the visual outcomes and adverse events associated with the 2 most commonly used contact lenses for treating aphakia in children: silicone elastomer (SE) and rigid gas permeable (RGP).

Methods

Literature searches were last conducted in January 2018 in the PubMed, Cochrane Library, and ClinicalTrials.gov databases with no date or language restrictions. These combined searches yielded 167 citations, 27 of which were reviewed in full text. Of these, 10 articles were deemed appropriate for inclusion in this assessment and subsequently assigned a level of evidence rating by the panel methodologist.

Results

The literature search identified 4 level II studies and 6 level III studies. There were insufficient data to compare visual outcomes for eyes treated using SE lenses versus RGP lenses. Silicone elastomer lenses have the advantage that they can be worn on an extended-wear basis, but they were associated with more adverse events than RGP lenses. These adverse events included microbial keratitis, corneal infiltrates, corneal edema, corneal scars, lenses adhering to the cornea, superficial punctate keratopathy, lid swelling, and conjunctival hyperemia. The lens replacement rate was approximately 50% higher for RGP lenses in the only study that directly compared SE and RGP lenses.

Conclusions

Limited evidence was found in the literature on this topic. Silicone elastomer and RGP contact lenses were found to be effective for treating aphakia in children. Silicone elastomer lenses are easier to fit and may be worn on an extended-wear basis. Rigid gas permeable lenses must be removed every night and require a more customized fit, but they are associated with fewer adverse events. The choice of which lens a practitioner prescribes should be based on the particular needs of each patient.

中文翻译：

---

儿童无晶状体的隐形眼镜矫正

目的

回顾已发表的文献，以评估与两种最常用于治疗儿童无晶状体的隐形眼镜相关的视觉结果和不良事件：有机硅弹性体（SE）和硬质透气性（RGP）。

方法

文献检索最后一次于2018年1月在PubMed，Cochrane图书馆和ClinicalTrials.gov数据库中进行，没有日期或语言限制。这些组合搜索产生了167条引用，其中27条经过了全文审查。其中，有10篇文章被认为适合纳入本评估，随后由专家组方法学家指定了一定的证据等级。

结果

文献检索确定了4个II级研究和6个III级研究。没有足够的数据来比较使用SE镜片和RGP镜片治疗的眼睛的视觉效果。有机硅弹性体镜片的优点是可以长时间佩戴，但与RGP镜片相比，它们带来的不良事件更多。这些不良事件包括微生物性角膜炎，角膜浸润，角膜水肿，角膜疤痕，附着在角膜上的晶状体，点状角膜性角膜病，眼睑肿胀和结膜充血。在唯一直接比较SE和RGP镜片的研究中，RGP镜片的镜片更换率高出约50％。

结论

在有关该主题的文献中发现的证据有限。发现有机硅弹性体和RGP隐形眼镜可有效治疗儿童无晶状体。硅酮弹性体镜片更易于安装，并且可能需要长时间佩戴。刚性透气镜必须每晚删除，并且需要更个性化的佩戴，但是与较少的不良事件相关。从业者开哪种镜片的选择应基于每个患者的特殊需求。