Article Text

other Versions

PDF
Risks and outcomes associated with primary intraocular lens implantation in children under 2 years of age: the IoLunder2 cohort study
  1. Ameenat Lola Solebo1,2,3,
  2. Isabelle Russell-Eggitt3,4,
  3. Phillippa M Cumberland1,3,
  4. Jugnoo S Rahi1,2,3,4
  5. on behalf of the British Isles Congenital Cataract Interest Group
  1. 1Life Course Epidemiology and Biostatistics Section, University College London Institute of Child Health, London, UK
  2. 2NIHR Moorfields Biomedical Research Centre / Institute of Ophthalmology, University College London, London, UK
  3. 3Ulverscroft Vision Research Group, Institute of Child Health, University College London, London, UK
  4. 4Great Ormond Street Hospital for Children, London, UK
  1. Correspondence to Professor J S Rahi, Life Course Epidemiology and Biostatistics Section, University College London Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK; j.rahi{at}ucl.ac.uk

Abstract

Background/aims To investigate outcomes following cataract surgery with and without primary intraocular lens (IoL) implantation in children under 2 years of age with congenital or infantile cataract.

Method Prospective population based cohort study undertaken through the British Isles Congenital Cataract Interest Group, with systematic data collection on children undergoing surgery in UK and Ireland between January 2009 and December 2010. ORs for the association between IoL implantation and visual acuity, postoperative glaucoma and reoperation at 1 year after surgery were estimated using multivariable regression analysis to control for potential confounders.

Results Of 221 children, 56/131 with bilateral and 48/90 with unilateral cataract underwent primary IoL implantation. IoL implantation was independently associated with better visual outcome in bilateral (OR 4.6, 95% CI 1.6 to 13.1, p=0.004) but not unilateral disease. IoL use increased the odds of reoperation requiring repeat general anaesthetic (bilateral OR 5.5, p<0.01; unilateral OR 16.7, p<0.01). IoL implantation did not reduce the odds of postoperative glaucoma.

Conclusions The use of IoLs in cataract surgery in young children should be critically reassessed, particularly used in settings/communities where close, long-term follow-up is challenging. The absence of visual benefit and the lack of a previously postulated protective effect against postoperative glaucoma serve to question the value of IoLs in unilateral disease. The potential association between IoL use and better early visual outcomes in bilateral disease needs to be balanced against the risk of reoperation and exposure to additional general anaesthetics during a key period of neurodevelopment.

  • Epidemiology
  • Child health (paediatrics)
  • Lens and zonules
  • Treatment Surgery

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • At a glance
    Keith Barton James Chodosh Jost Jonas