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Use of the Delphi process in paediatric cataract management
  1. Massimiliano Serafino1,
  2. Rupal H Trivedi2,
  3. Alex V Levin3,
  4. M Edward Wilson2,
  5. Paolo Nucci1,
  6. Scott R Lambert4,
  7. Ken K Nischal5,
  8. David A Plager6,
  9. Dominique Bremond-Gignac7,
  10. Ramesh Kekunnaya8,
  11. Sachiko Nishina9,
  12. Nasrin N Tehrani10,
  13. Marcelo C Ventura11
  1. 1University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy
  2. 2Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA
  3. 3Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  4. 4Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA
  5. 5Eye Center of the University of Pittsburgh Medical Center and Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
  6. 6Glick Eye Institute, Indiana University, Indianapolis, Indiana, USA
  7. 7Ophthalmology Department, University Hospital, UPJV, Amiens, CNRS FR3636, Paris V University, Paris, France
  8. 8Jasti V Ramanamma Children's Eye Care Centre, LV Prasad Eye Institute, Hyderabad, India
  9. 9National Center for Child Health and Development, Tokyo, Japan
  10. 10The Hospital for Sick Children and University of Toronto, Toronto, Canada
  11. 11Altino Ventura Foundation and HOPE Eye Hospital, Recife, Brazil
  1. Correspondence to Dr Alex V Levin, Chief, Pediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital, 840 Walnut Street, Suite 1210, Philadelphia, PA 19107-5109, USA; alevin{at}


Purpose To identify areas of consensus and disagreement in the management of paediatric cataract using a modified Delphi approach among individuals recognised for publishing in this field.

Design A modified Delphi method.

Participants International paediatric cataract experts with a publishing record in paediatric cataract management.

Methods The process consisted of three rounds of anonymous electronic questionnaires followed by a face-to-face meeting, followed by a fourth anonymous electronic questionnaire. The executive committee created questions to be used for the electronic questionnaires. Questions were designed to have unit-based, multiple choice or true–false answers. The questionnaire included issues related to the preoperative, intraoperative and postoperative management of paediatric cataract.

Main outcome measure Consensus based on 85% of panellists being in agreement for electronic questionnaires or 80% for the face-to-face meeting, and near consensus based on 70%.

Results Sixteen of 22 invited paediatric cataract surgeons agreed to participate. We arrived at consensus or near consensus for 85/108 (78.7%) questions and non-consensus for the remaining 23 (21.3%) questions.

Conclusions Those questions where consensus was not reached highlight areas of either poor evidence or contradicting evidence, and may help investigators identify possible research questions.

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