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Review
. 2017 Jun;94(6):638-646.
doi: 10.1097/OPX.0000000000001078.

The Safety of Soft Contact Lenses in Children

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Free PMC article
Review

The Safety of Soft Contact Lenses in Children

Mark A Bullimore. Optom Vis Sci. .
Free PMC article

Abstract

Purpose: There is increasing interest in fitting children with soft contact lenses. This review collates data from a range of studies to estimate the incidence of complications, specifically corneal infiltrative events and microbial keratitis, in patients under the age of 18 years.

Methods: Peer-review papers were identified using PubMed and the Web of Science. A broad range of studies are summarized including large-scale epidemiological studies of contact lens-related complications, hospital-based case series, long- and short-term prospective studies, and multicenter retrospective studies.

Results: Nine prospective studies representing 1800 patient years of wear in 7- to 19-year-olds include safety outcomes. In three large prospective studies representing between 159 and 723 patient years of soft contact lens wear in patients 8 to 14 years, the incidence of corneal infiltrative events is up to 136 per 10,000 years. Data from a large retrospective study show similar rates of corneal infiltrative events: 97 per 10,000 years in 8- to 12-year-olds (based on 411 patient years of wear) and 335 per 10,000 years in 13- to 17-year-olds (based on 1372 patient years of wear). None of the prospective studies report any cases of microbial keratitis. Five clinical studies where safety data are not reported constitute a further 493 patient years. One retrospective study found no cases of microbial keratitis occurred in 8- to 12-year-olds (411 patient years) and an incidence of 15 per 10,000 patient years in 13- to 17-year-olds (1372 patient years)-no higher than the incidence of microbial keratitis in adults wearing soft contact lenses on an overnight basis.

Conclusions: The overall picture is that the incidence of corneal infiltrative events in children is no higher than in adults, and in the youngest age range of 8 to 11 years, it may be markedly lower.

Figures

FIGURE 1
FIGURE 1
The age at which practitioners (N = 576) feel it appropriate to introduce a child to soft contact lenses. Replotted from data reported by Sindt and Riley.
FIGURE 2
FIGURE 2
The incidence of various corneal infiltrative events as a function of patient age. Incidence was calculated per 10,000 patient years. Calculated from data reported by Chalmers et al.

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