Improvement of Postoperative Visual Outcomes in Children With Primary Congenital Glaucoma

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PURPOSE: To investigate the vision improvement of corneal rigid gas permeable contact lenses (RGPCLs) in children with primary congenital glaucoma (PCG), compared with spectacles. METHODS: This cross-sectional analysis used baseline data from a randomized trial (CLEVR-PCG Study) investigating RGPCLs' impact on postoperative vision rehabilitation in children with PCG with controlled intraocular pressure from April 2022 to August 2023. The study included 51 eyes from 29 children aged 7.41±2.51 years. Refractive errors were corrected first with spectacles, then RGPCLs. Best spectacle-corrected visual acuity (BSCVA) and best RGPCL-corrected visual acuity (BCLVA) and contrast sensitivity function (CSF) were compared. RESULTS: BCLVA was better than BSCVA, and CSF with RGPCLs was better than with spectacles: BCLVA 0.30 (0.15, 0.52) LogMAR vs. BSCVA 0.40 (0.30, 0.70) LogMAR; area under the logarithm of the CSF (AULCSF) 0.68±0.38 vs. 0.51±0.33; CSF acuity 0.94±0.29 vs. 0.83±0.29 (all P <0.001). Multivariate linear regression showed greater myopic spherical equivalent (SER) associated with greater BCVA improvement (β=0.01, 95% CI: 0.004-0.02; P <0.001) and CSF acuity improvement (β=-0.01, 95% CI: -0.01 to -0.0005; P =0.036). Greater myopic SER (β=-0.01, 95% CI -0.02 to -0.004) and better BSCVA (β=-0.18, 95% CI: -0.32 to -0.04) associated with greater AULCSF improvement ( P =0.007). CONCLUSION: RGPCLs immediately improved vision in children with PCG. These findings suggest that RGPCLs are potentially useful for visual rehabilitation in this population.

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