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Clinical science
Cataract surgery and primary intraocular lens implantation in children ⩽2 years old in the UK and Ireland: finding of national surveys
  1. A L Solebo1,2,
  2. I Russell-Eggitt2,3,
  3. K K Nischal2,3,
  4. A T Moore2,3,4,5,
  5. P Cumberland1,2,
  6. J S Rahi1,2,3,4,5
  1. 1
    MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UK
  2. 2
    Ulverscroft Vision Research Group, UCL Institute of Child Health, London, UK
  3. 3
    Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, UK
  4. 4
    Moorfields Eye Hospital, London, UK
  5. 5
    UCL Institute of Ophthalmology, London, UK
  1. Correspondence to Dr J Rahi, MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK; j.rahi{at}


Background: Current patterns of practice relating to primary intraocular lens (IOL) implantation in children ⩽2 years old in the UK and Ireland are investigated.

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

Results: 76% of 928 surveyed ophthalmologists replied. 47 (7%) of the respondents operated on children aged ⩽2 with cataract. 41 (87%) of respondents performed primary IOL implantation, but 25% would not implant an IOL in a child under 1 year old. 88% of surgeons used limbal wounds, 80% manual capsulotomies, 98% posterior capsulotomies and 100% hydrophobic acrylic lenses. The SRK/T formula was most commonly used (70%). Exclusion criteria for primary IOL implantation varied considerably and included microphthalmos (64% of respondents), anterior and posterior segment anomalies (53%, 58%), and glaucoma (19%).

Discussion: Primary IOL implantation in children ⩽2 has been widely adopted in the UK and Ireland. There is concordance of practice with regards to surgical technique and choice of IOL model. However, there is some variation 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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  • Funding ALS is supported by a fellowship awarded by the Ulverscroft Vision Research Group. The Centre for Paediatric Epidemiology and Biostatistics at ICH also benefits from funding support from the Medical Research Council in its capacity as the MRC Centre of Epidemiology for Child Health. This work was undertaken at UCL Institute of Child Health/Great Ormond Street Hospital for children, which received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme. JSR is supported in part by the Moorfields Eye Hospital/UCL Institute of Ophthalmology, which also receives a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme.

  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

  • Members of the British Isles Congenital Cataract Interest Group: M Abdel-Khalek, Pilgrim Hospital, Lincolnshire, W Aclimandos, King’s College Hospital, London, GW Adams, Moorfields Eye Hospital, London, S Aftab, Scunthorpe General Hospital, A Aguirre Vila-Coro, Huddersfield Royal Infirmary, L Allen, Addenbrokes Hospital, Cambridge, L Amanat, James Paget Hospital, Norfolk, L Amaya, St Thomas’ Hospital, London, S Anwar, Leicester Royal Infirmary, S Armstrong, Countess of Chester Hospital, Cheshire, A Assaf, Milton Keynes Hospital, N Astbury, West Norwich Hospital, J Ashworth, Manchester Royal Eye Hospital, Bates, Pembury Hospital, Tonbridge Wells, A Beckingsale, Essex County Hospital, G Bedford, Dumfries & Galloway Royal Infirmary, L Benjamin, Stoke Mandeville Hospital, Buckinghamshire, B Billington, Royal Berkshire Hospital, S Biswas, Manchester Royal Eye Hospital, A Blaikie, Queen Margaret Hospital, Fife, T Blamires, Northampton General Hospital, P Bloom, Western Eye Hospital, London, D Boase, Queen Alexandra Hospital, Hampshire, M Boodhoo, St Peter’s Hospital, Surrey, R Bowman, Yorkhill Hospital, Glasgow, J Bradbury, Bradford Royal Infirmary, J Brazier, Middlesex Hospital, London, A Bron, Oxford Eye Hospital, D Brosnahan, Our Lady’s Children Hospital, Dublin, R Brown, North Staffordshire University Hospital, I Brown, Old Rectory, Shropshire, S Bryan, Whipps Cross Hospital, London, P Burgess, Princess Margaret Hospital, Swindon, J Burke, Royal Hallamshire Hospital, Sheffield, J Butcher, Countess of Chester Hospital, Cheshire, L Butler, Birmingham & Midland Eye Centre, D Calver, Guy’s Hospital, London, A Casswell, Sussex Eye Hospital, A Chandna, Alder Hey Children’s Hospital, Liverpool, AJ Churchill, Bristol Eye Hospital, J Clarke, James Cook University Hospital, Middlesborough, M Clarke, Royal Victoria Infirmary, Newcastle upon Tyne, Coffey, Ireland, M Cole, Torbay Hospital, Devon, R Condon, St Peter’s Hospital, Surrey, P Corridan, Wolverhampton Eye Infirmary, M Dang, Darlington Memorial Hospital, Co Durham, R Darvell, Kent and Canterbury Hospital, B Das, Alexandra Hospital, Worcestershire, S Daya, Queen Victoria Hospital, West Sussex, R De Cock, Kent and Canterbury Hospital, F Dean, University Hospitals Coventry and Warwickshire, C Dees, James Cook University Hospital, Middlesborough, C Dodd, Manchester Royal Eye Hospital, R Doran, Victoria Eye Centre, Hereford, G Dutton, Yorkhill Hospital, Glasgow, C Edelsten, Ipswich Hospital, R Edwards, Kent and Canterbury Hospital, H El-Kabasy, Southend Hospital, J Elston, Oxford Eye Hospital, A Evans, Queen Alexandra Hospital, Portsmouth, N Evans, Royal Eye Infirmary, Plymouth, F Fahy, Leicester Royal Infirmary, J Ferris, Cheltenham General Hospital, A Fielder, Western Eye Hospital, London, D Flaye, Herts and Essex Hospital, B Fleck, Princess Alexandra Eye Pavilion, Edinburgh, A Gaskell, Ayr Hospital, ND George, Ninewells Hospital, Dundee, M Gibbens, Queen Mary’s Hospital, Kent, C Gibbons, North Devon District Hospital, L Gnanaraj, Sunderland Eye Infirmary, P Gregory, Conquest Hospital, East Sussex, R Gregson, Nottingham University Hospital, J Hakim, Queen Mary’s Hospital, Sidcup, S Hardman-Lea, Ipswich Hospital, M Hassan, Barnsley District Hospital, M Heravi, William Harvey Hospital, Kent, M Hingorani, Bedford Hospital, P Hodgkins, Southampton General Hospital, R Holden, Derbyshire Royal Infirmary, R Humphrey, Odstock Hospital, Salisbury, C Hutchinson, Royal Halifax Infirmary, J Innes, Hull Royal Infirmary, I Jalili, Roman Bank, Peterborough, C Jenkins, Kent County Ophthalmic and Aural Hospital, E Johnson, Gloucestershire Royal Hospital, D Jones, Royal Cornwall Hospital, A Joseph, North Staffordshire University Hospital, N Kaushik, Wrexham Maelor Hospital, Wales, N Kayali, Whipps Cross Hospital, London, S Keightley, North Hampshire Hospital, Basingstoke, P Khaw, Moorfields Eye Hospital, London, P Kinnear, Charing Cross Hospital, London, A Kostakis, Doncaster Royal Infirmary, S Kotta, Grimsby District General Hospital, R Kumar, Coventry and Warwickshire Hospital, T Lavy, Yorkhill Hospital, Glasgow, D Laws, Singleton Hospital, Swansea, J Leitch, Sutton Hospital, Surrey, C Liu, Sussex Eye Hospital, C Lloyd, Manchester Royal Eye Hospital, C MacEwen, Ninewells Hospital, Dundee, G Mackintosh, Yew Tree House, Cheltenham, A Mandal, Barnsley District Hospital, R Markham, Bristol Eye Hospital, E Mc Loone, Royal Victoria Hospital, Belfast, J McConnell, Ferrers, Kent, G McGinnity, Royal Victoria Hospital, Belfast, B McLeod, Sussex Eye Hospital, W Moore, Great Ormond Street Children’s Hospital, London, B Moriarty, Leighton Hospital, Cheshire, G Morrice, Stirling Royal Infirmary, R Morris, Southampton Eye Hospital, N Neugebager, Leighton Hospital, Cheshire, W Newman, Alder Hey Children’s Hospital, Liverpool, J Nolan, University College Hospital, London, G O’Connor, Cork University Hospital, Ireland, R Ohri, Whipps Cross Hospital, London, M O’Keefe, Children’s Hospital, Dublin, J Pauw, Clacton Hospital, Wakefield, S Perry, Kidderminster General Hospital, R Phillips, Arrowe Park Hospital, Wirral, B Power, Dumfries and Galloway Royal Infirmary, N Price, Cheltenham General Hospital, AG Quinn, Royal Devon and Exeter Hospital, I Qureshi, Birch Hill Hospital, Lancashire, A Rahman, Pilgrim Hospital, Lincolnshire, A Reddy, Royal Aberdeen Children’s Hospital, E Rosen, St John Street, London, S Scotcher, Hereford Hospital, CS Scott, Royal Aberdeen Children’s Hospital, J Scott, Stirling Royal Infirmary, P Sellar, West Cumberland Hospital, J Shankar, Wrexham Maelor Hospital, Wales, A Shun Shin, Wolverhampton Eye Infirmary, P Simcock, Royal Devon and Exeter Hospital, I Simmons, St James’ University Hospital, Leeds, JD Stokes, Nottingham University Hospital, M Tappin, St Peter’s Hospital, Surrey, DSI Taylor, Institute of Ophthalmology, London, R H Taylor, York Hospitals NHS Foundation Trust, V Thaller, Royal Eye Infirmary, Blackburn, M Thoung, Broomfield Hospital, Essex, W Tormey, Waterford Regional Hospital, Ireland, S Tuft, Moorfields Eye Hospital, London, M Tutton, Countess of Chester Hospital, Cheshire, J Twomey, Musgrove Park Hospital, Somerset, S Verghese, West Cumberland Hospital, Cumbria, S Vickers, Sussex Eye Hospital, Brighton, A Vijaykumar, The Royal Infirmary, Lancashire, A Vivian, West Suffolk Hospital, P Watts, Cardiff Eye Unit, C Williams, Bristol Eye Hospital, H Wilshaw, Birmingham & Midland Eye Centre, G Woodruff, Leicester Royal Infirmary, G Wright, Burnley General Hospital, Lancashire, and Young, Limerick Regional Hospital, Ireland.

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