Causes And Managements Of Contact Lens Drop Out In Aphakia After Congenital Cataract Surgery

To investigate the causes of contact lens(CL) drop out in pediatric aphakia following congenital cataract surgery and to evaluate subsequent clinical management outcomes.

This study was conducted at a tertiary referral university eye clinic and included pediatric aphakic eyes following congenital cataract surgery.

Medical records of 91 pediatric patients (46 female, 45 male) who underwent congenital cataract surgery between 2018 and 2025 and attended regular follow-up visits were retrospectively reviewed. CL treatment was initiated as early as possible postoperatively. No toric lenses were prescribed to any patient. Nineteen eyes with documented CL non-compliance were included in the analysis. Demographic data and clinical findings were recorded.

Of the included patients, 33.3% (4) were female and 66.6% (8) male. Mean follow-up was 54.84±36.79 months (9–96), and mean time to surgery was 11.33±4.92 weeks (3–19). CL initiation occurred at 4.68±3.66 days, with mean use of 18.57±18.87 months. Mean spherical power was +27.52±4.63 D; BC 7.79±0.35 mm, DIA 11.75±0.58 mm, AL 18.98±2.38 mm, WTW 10.85±0.78 mm. The mean time to CL discontinuation was 1.15±0.85 months. Causes were unwillingness 10.5% (2), irritation 36.8% (7), economic barriers 36.8% (7), and lens loss 15.8% (3). After discontinuation, spectacles were prescribed in 10.5% (2), CLs replaced in 47.4% (9), and secondary IOL implanted in 42.1% (8).

CL non-compliance in pediatric aphakia following congenital cataract surgery represents a significant postoperative challenge. Ocular intolerance and socioeconomic barriers are the primary determinants of early discontinuation. Family education, individualized CL planning, and close clinical follow-up play a critical role in maintaining adherence and ensuring effective visual rehabilitation during the amblyogenic period.