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Lola A. Solebo, Jugnoo S. Rahi, British Isles Congenital Cataract Interest Group (BCCIG); British Isles Study Of Primary Intraocular Lens Implantation In Children 2years Old With Congenital/infantile Cataract (IOLunder2). Invest. Ophthalmol. Vis. Sci. 2011;52(14):6323.
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© ARVO (1962-2015); The Authors (2016-present)
IOL implantation in early childhood has been widely advocated despite uncertainties regarding the risks and benefits. IOLunder2 aims to investigate current practice and outcomes following cataract surgery with/without IOLs in children ≤2.
A British Isles prospective cohort study of children undergoing surgery between 01/01/2009 & 31/12/2010, undertaken through a collaborative research network with comprehensive standardised collection of pre/per-operative, 6 & 12 month postoperative data.
150 children (57% bilateral cataract, total 232 eyes) recruited to date. Cataract was diagnosed in the first month of life in 61% of children. 62 children (41%) had other ocular abnormalities, with persistent fetal vasculature (PFV) in 28 children (19%). Primary IOLs were implanted in 79 children (53%; 36/86 or 42% of children with bilateral cataract, 43/64 or 67% with unilateral cataract; total 116 eyes); specifically in 41/105 (39%) of children aged ≤6months at surgery. In this age subgroup, there was no difference in median age at surgery with or without IOL. (48v49 days). The SRK/T or HofferQ formula was used for IOL power calculation in 78% of children. Following IOL implantation, the discrepancy between the planned and actual initial refractive outcome was >1D in 60% of eyes. Intraoperative complications occurred in 30 eyes undergoing implantation (26%, 95%C.I. 18%-34%), versus 24 eyes not undergoing implantation (20.6%).
In UK/Ireland, infant primary IOL implantation is not universal. This may reflect surgeon’s concerns about outcomes in the presence of other abnormalities, for example PFV (which was much more common than previously reported), but other factors, such as the child’s age and ocular biometrics, are likely to be relevant. The final IOLunder2 cohort is anticipated to be >200 children (>100 with primary IOL). This will allow robust analysis of associations putative risk factors and outcomes following surgery with/without IOLs.
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