RGPs Rehabilitate Vision Following Penetrating Ocular Trauma, Despite Challenges

Rigid gas permeable lenses (RGPs) rehabilitate vision in pediatric patients with penetrative ocular trauma and can help these individuals avoid amblyopia, according to an investigation published in Eye & Contact Lens. However, concerns regarding their discomfort, safety, cost, and complexity may limit their use, according to the report.

Researchers performed a retrospective chart review of children (mean age, 8.0 years; boys, 10; mean RGP wear duration, 20.3 months) with a history of penetrative ocular trauma who used RGPs for visual rehabilitation. Study participants underwent RGP fitting and training on lens cleaning, care, insertion, and removal. Testing included corneal morphometry prior to fitting and corneal topography at follow-up visits conducted at 1 week, 1 month, and every 3 months thereafter. 

The children experienced visual acuity improvements with RGP rehabilitation, according to the report. Best-corrected visual acuity (BCVA) was 0.4 (95% CI, 0.2–0.7) logarithm of the minimum angle of resolution (logMAR) with spectacles and 0.1 (95% CI, 0.1–0.2) logMAR with RGPs at the initial visit. Participants’ BCVA improved to 0.0 (95% CI, 0.0–0.1) logMAR at the final visit, a statistically significant difference between the 3 comparisons (P < .001).

Despite improved BCVA outcomes demonstrating that RGPs rehabilitate vision, the report shows a high dropout rate due to a variety of contact lens-related challenges. Overall, 40% of the children (n =6) discontinued lens wear for a variety of reasons including discomfort (n=3), high cost (n=1) and a broken or lost lens (n=2).

“Unlike adults, children are more likely to acquire poor final vision because of amblyopia after ocular trauma,” the study authors explain. “Therefore, visual rehabilitation needs to be more timely and complete to avoid amblyopia and to maximize the final BCVA in children with ocular trauma.”

Study limitations include a small sample size, short follow-up duration, and incomplete medical record data.