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Cataract surgery and primary intraocular lens implantation in children ≤2 years old in the United Kingdom and Ireland: findings of national surveys
  1. Ameenat Lola Solebo (l.solebo{at}ich.ucl.ac.uk),
  2. Isabelle Russell-Eggitt (eggiti{at}gosh.nhs.uk),
  3. Ken K Nischal (kkn{at}btinternet.com),
  4. Anthony T Moore (tony.moore{at}ucl.ac.uk),
  5. Phillippa Cumberland (p.cumberland{at}ich.ucl.ac.uk),
  6. Jugnoo Rahi (j.rahi{at}ich.ucl.ac.uk),
  7. British Isles Congenital Cataract Interest Group .
  1. MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, United Kingdom
  2. Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, United Kingdom
  3. Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, United Kingdom
  4. Institute of Ophthalmology, United Kingdom
  5. MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, United Kingdom
  6. MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, United Kingdom
  7. British Isles Congenital Cataract Interest Group, United Kingdom

    Abstract

    Background: We have investigated the current patterns of practice relating to primary intraocular lens (IOL) implantation in children ≤2 years old in the UK and Ireland.

    Methods: National postal questionnaire surveys of consultant ophthalmologists in the UK & Ireland.

    Results: 76% of 928 surveyed ophthalmologists replied. 47 (7%) of the respondents operated on children aged under ≤2 with cataract. 41 (87%) of the 47 respondents performed primary IOL implantation in these children, but a quarter of respondents would not implant an IOL in a child under 1 year old. The 41 respondents had used IOLs in 173 children over a 1 year period. 88% of surgeons used limbal wounds, 80% used manual capsulotomies, 98% used posterior capsulotomies, and 100% used hydrophobic acrylic lenses. The SRK/T formula was most commonly (70%) used to calculate IOL power. Exclusion criteria for primary IOL implantation varied considerably and included microphthalmos (70% of respondents), anterior and posterior segment anomalies (52%, 61%), and glaucoma (19%).

    Discussion: Primary IOL implantation in children ≤2 has been widely adopted in the UK & Ireland by the relatively small number of ophthalmologists who manage these children. There is concordance of practice with regards to surgical technique, choice of IOL model and choice of power calculation formula. However, variation exists in eligibility criteria for primary IOLs: this may reflect a lack of consensus on which children are most likely to benefit. Thus there is a need for systematic studies of the outcomes of primary IOL implantation in younger children.

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