Enhancing Pediatric Vision Post-Glaucoma Surgery: The Role of Rigid Gas-Permeable Contact Lenses

Rigid gas‑permeable contact lenses (RGPCLs) were reported to produce greater visual rehabilitation at 12 months than spectacles after primary congenital glaucoma surgery.

Recent research cited improvements in best-corrected visual acuity (BCVA), reporting mean changes of approximately 0.31 versus 0.12 logMAR in favor of RGPCLs at 12 months and noting that 62.5% of RGPCL users gained two lines of acuity.

Which children are most likely to benefit? Those with limited or inconsistent acuity gains despite optimized spectacles — especially children with high irregular astigmatism or clinically significant anisometropia — because rigid lenses regularize the tear lens and corneal optics.

Benefit is also contingent on ocular anatomy permitting lens wear and on adequate caregiver or patient capacity for safe handling and adherence. In practice, consider contact‑lens fitting when expected spectacle‑based gains are not achieved and family support for insertion, cleaning, and follow‑up is available.

Management and follow‑up consequences include individualized fitting, close monitoring, and structured visual‑rehabilitation milestones to preserve gains. With careful fitting and attentive follow‑up, one‑year gains are likely to be sustained and complications minimized.

Key Takeaways:

• RGPCLs were associated with greater 12‑month visual gains than spectacles after congenital glaucoma surgery — the primary trial should be cited to confirm these early findings.
• Children with poor spectacle response, marked irregular astigmatism or anisometropia, and families able to support contact‑lens care are the main beneficiaries.
• Aligning access to RGPCL fitting, timely postoperative referral, and structured follow‑up into care pathways will help translate reported gains into routine postoperative rehabilitation.