Use of IOLs in pediatric cataract surgery increases

WAIKOLOA, Hawaii — Pediatric ophthalmologists are implanting IOLs at five times the rate they were in 1993, according to a survey of members of the American Association for Pediatric Ophthalmology and Strabismus.

The 2001 survey found an increase in IOL implantations in children under age 2. The AAPOS Pediatric Cataract Surgery and Intraocular Lens Implantation Survey was described in a poster presentation here at the annual AAPOS meeting.

M. Edward Wilson, MD, and colleagues found that as implantation rates increased, the minimum age for unilateral implantation dropped from 4 years in 1993 to 1 year in 2001.

Similarly, in 1993, the minimum age for bilateral IOL implantation was 7 years. In 2001, the minimum age had dropped to 2 years.

Twenty-eight percent of the 402 AAPOS members who responded to the survey said they do not perform pediatric cataract surgery. Of surgeons who perform pediatric cataract surgery, 61% used a manual anterior approach, and 11% used a manual posterior approach. Of the respondents, 85% said they would not consider an anterior chamber IOL for a young child.

Vitrectomy was routine for 92% of respondents. Eighty-six percent said they perform posterior capsulotomy using an automated vitrector.

Finally, 96% of surgeons said they suture their tunnel incisions at the conclusion of surgery, while 41% suture their paracentesis incisions.