Purpose

To report the use of a custom-designed, scleral contact lens (SL) in the treatment of pediatric patients.

Methods

The medical records of all patients under 15 years of age fitted with SL from March 2018 through February 2020 were retrospectively reviewed. Ophthalmic diagnosis, prior surgical intervention, lens wearing failures, and duration of lens use are reported.

Results

Lenses were dispensed to 18 patients (24 eyes). Main indications for SL fitting were refractive error correction (n = 18: keratoconus (KCN), traumatic corneal scarring, corneal transplant status, and aphakia) and ocular surface protection and optimization (n = 6: neurotrophic keratitis and chronic blepharokeratoconjunctivitis). Patient age ranged from 16 months to 14 years (mean, 9.9 ± 3.5 years (mean ± standard deviation (SD)). Patients fitted for surface disease indications were significantly younger, 8.8 ± 2.5 years. The mean maximal keratometry reading in patients with keratoconus was 64.0 ± 12.6 diopters (D). In six eyes with advanced KCN (Kmax 71.8 ± 11.0 D) and three eyes with traumatic scarring, SL use obviated the need for keratoplasty. Fifteen patients (83 %) continued scleral lens wear with a mean follow-up period of 9.2 ± 7.4 months. Complications included one case of corneal graft rejection and one corneal abrasion associated with lens insertion.

Conclusions

The goals of SL fitting in pediatric patients are visual rehabilitation and ocular surface protection. Pediatric patients with advanced keratoconus and traumatic corneal scarring are most appreciative of the benefits of scleral lenses. The challenges associated with SL fitting and the training process did not preclude long-term SL wear.

中文翻译：

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儿童人群中的巩膜隐形眼镜——适应症和结果

目的

报告使用定制设计的巩膜隐形眼镜 (SL) 治疗儿科患者。

方法

回顾性回顾了2018年3月至2020年2月所有15岁以下的SL患者的病历。报告了眼科诊断、先前的手术干预、镜片佩戴失败和镜片使用时间。

结果

向 18 名患者（24 只眼睛）配发了镜片。SL 拟合的主要适应症是屈光不正矫正（n = 18：圆锥角膜 (KCN)、外伤性角膜瘢痕、角膜移植状态和无晶状体）和眼表保护和优化（n = 6：神经营养性角膜炎和慢性睑角结膜炎）。患者年龄从 16 个月到 14 岁不等（平均 9.9 ± 3.5 岁（平均 ± 标准差 (SD)）。适合表面疾病适应症的患者显着年轻，为 8.8 ± 2.5 岁。圆锥角膜患者的平均最大角膜曲率读数为 64.0 ± 12.6 屈光度 (D)。在 6 只患有晚期 KCN (Kmax 71.8 ± 11.0 D) 的眼睛和 3 只患有外伤性疤痕的眼睛中，SL 的使用避免了角膜移植术的需要。15 名患者 (83 %) 继续佩戴巩膜镜，平均随访期9.2±7.4个月。

结论

SL 适合儿科患者的目标是视力康复和眼表保护。患有晚期圆锥角膜和外伤性角膜瘢痕的儿科患者最欣赏巩膜镜的益处。与 SL 装配和训练过程相关的挑战并不排除长期 SL 磨损。