Current trends in the use of intraocular lenses in children

We present an overview of current practice patterns as they apply to intraocular lens (IOL) implantation in children. Two hundred and thirty-four members of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) and 1,039 members of the American Society of Cataract and Refractive Surgery (ASCRS) responded to a questionnaire. Forty-six percent of AAPOS respondents and 27% of ASCRS respondents reported that they are currently implanting IOLs in children. Although the majority have implanted lenses in children older than six years, 16 AAPOS members and 41 ASCRS members reported implanting IOLs in patients in their first two years of life. Eighty-four percent of the respondents use the continuous curvilinear capsulorhexis technique of anterior capsulotomy in children. When a primary posterior capsulotomy is performed, 63 ASCRS surgeons (38%) reported using posterior continuous curvilinear capsulorhexis. Fixation of an IOL in the ciliary sulcus in a child was acceptable to 67% of the surgeons; however, 86% would not consider implanting an anterior chamber IOL in a child. Implications of the survey data are discussed.