Gas-Permeable Lenses Aid Vision After Glaucoma Surgery

Children who undergo surgery for primary congenital glaucoma (PCG) may experience significantly better visual outcomes when fitted with rigid gas-permeable contact lenses (RGPCLs) compared to spectacles, according to a randomized clinical trial published in JAMA Ophthalmology.

Comparative Study: RGPCLs vs. Spectacles

The study, led by Jinyun Jiang, MD, PhD, from the State Key Laboratory of Ophthalmology in Guangzhou, China, evaluated the visual improvement potential of RGPCLs in pediatric PCG patients aged 4 to 15 who had shown a poor response to spectacle correction following glaucoma surgery.

A total of 56 children with surgically managed PCG were enrolled. Participants were randomly assigned to either the RGPCL group (n = 29) or the spectacle group (n = 27). All participants received standardized amblyopia patching therapy in addition to their respective corrective devices and were followed over a 12-month period.

Key Findings: Improved Visual Acuity and Contrast Sensitivity

At baseline, the mean worse-eye spherical equivalents were −6.55 diopters in the RGPCL group and −5.17 diopters in the spectacle group. Baseline best corrected visual acuity (BCVA) was similar between groups at 0.99 and 1.02 logMAR, respectively (equivalent to approximately 20/200 Snellen).

After one year:

• BCVA improvement was significantly greater in the RGPCL group (mean improvement of 0.31 logMAR) compared to the spectacle group (0.12 logMAR).

• 62.5% of children in the RGPCL group gained two or more lines of BCVA, compared with 37.5% in the spectacle group (odds ratio: 6.83).

• The RGPCL group showed greater improvement in contrast sensitivity function (0.40 vs. 0.13).

• Near stereoacuity of 60 arcseconds or better was achieved by 50.0% in the RGPCL group, compared to 25.0% in the spectacles group (odds ratio: 6.96).

Safety Profile and Clinical Implications

Importantly, no serious adverse events were reported in either group during the trial. The researchers concluded that RGPCLs represent a safe and effective alternative to spectacles for children with PCG who respond poorly to conventional corrective lenses.

Reference:

Jinyun Jiang et al, Visual Outcomes of Children With Primary Congenital Glaucoma Receiving Different Refractive Corrections, JAMA Ophthalmology (2025). DOI: 10.1001/jamaophthalmol.2025.3976