Children with postoperative congenital cataracts are rarely fitted with IOLs before the age of 2 because their eyes are still developing rapidly, so they need to wear glasses after surgery to improve their vision. However, because of the thick and heavy highly hyperopic lenses and the distortion of peripheral vision, especially in children with monocular cataracts and aphakic eyes, it is difficult to establish binocular stereopsis due to the severe refractive aberration in both eyes, and it is also difficult to avoid nystagmus, strabismus and monocular amblyopia. Therefore, early prescription of RGP can restore good visual function of the child. Clinical practice proves that rigid oxygen permeable corneal contact lenses can safely and effectively correct postoperative aphakic eyes of infants and children with congenital cataracts, and buy time and lay a good foundation for future IOL implantation and recovery and establishment of binocular vision. Furthermore, studies have shown that RGP for children with nystagmus can effectively suppress the amplitude and frequency of nystagmus and improve the visual quality of the children to a certain extent.
How old is a baby for RGP?
RGP has high oxygen permeability and good wearing comfort, so there is no strict age limit, but for children of different ages, due to many issues such as cooperation and compliance, whether they can wear RGP needs to be personalized.
1, from birth to 3 months of age, because the macula has not yet developed, macular gaze has not yet formed, the diameter of the infant cornea and lid fissure is too small, RGP lenses are difficult to wear, so there is no need to fit RGP in this age group.
2. Children between the ages of 3 months and 2 years are the prime age for RGP fitting, mainly because of the degree of cooperation and compliance.
3. Children between the ages of 2 and 3 need to be flexible, depending on their degree of cooperation and parents’ wishes and compliance.
4. 3 to 5 years old, in most cases, the fitting fails due to the degree of cooperation, and even if the fitting is successful, more than half of them interrupt wearing the lens due to the high rate of lens loss.
5. The success rate of RGP fitting increases significantly over the age of 5, but most of the cases are discontinued for various reasons, such as post-cataract surgery for aphakic eyes, which can be discontinued because of IOL implantation, and nystagmus, which is mostly treated with surgery if surgery is indicated, but RGP can still be worn after surgery.
The process of RGP fitting.
1.Understanding the medical history.
2.Full communication.
3.Eye examination.
4.Dilated pupil examination.
5, corneal curvature examination.
6.Selecting lens base arc.
7, RGP fitting and trial evaluation.
8.Lens booking.
9.Lens collection and training for parents and wearers.
Precautions for parents and patients in the process of RGP fitting.
1. rigid high oxygen permeable corneal contact lenses are highly consumable medical optical products and long-term wearers need to pay for the costs required for lens renewal or damage, consumption of care packages and review and evaluation.
2. parents are able to complete the entire orthodontic process under the guidance of the dispensing personnel.
3, parents are able to contact the hospital in time for any situation that arises during the orthodontic process; must understand the problems that may arise during the orthodontic process, and be able to accept and actively cooperate.
4, parents must clearly know the importance of adherence and can actively review as required.
5.Infants with aphakia must pay attention to the dilated eye examinations every 3 months, and need to replace the lenses if the refractive error changes significantly; in other cases, the time of dilated eye examinations should be every 6 months or depending on the condition.