Congenital cataract and pseudophakia – myopia control in an unusual initial condition

Purpose. An effective reduction in the progression of myopia can be achieved by pharmacological administration of low-dose atropine eye drops, the fitting of multifocal and Ortho-K contact lenses or with specialized spectacle lenses. The case report describes the successful stabilization of myopia and visual acuity in a 14-year-old patient who had a posterior chamber IOL implanted at the age of 2 as a result of a congenital cataract.

Material and Methods. A 14-year-old untreated patient with pseudophakia after congenital cataract, was fitted with multifocal rigid-gas permeable (RGP) contact lenses for high myopia, irregular astigmatism, anisometropia and nystagmus to increase visual acuity and prevent myopia progression.

Results. With the fitted contact lenses, good lenses tolerance was achieved with a daily wearing time of 12 hours and an increase of visual acuity from spectacle-corrected visual acuity (20/160) to contact lens-corrected visual acuity (20/40) and stabilization of myopia over 3.5 years. With the contact lenses in combination with progressive spectacles, it was possible to achieve an additional increase in near vision and successful treatment of the patient. With her new quality of life, the patient can now complete school education independently and start an apprenticeship.

Conclusion. Pseudophakic children with high myopia and astigmatism can also be successfully fitted with multifocal contact lenses with the aim of increasing visual acuity and stabilizing myopia.