A 12-year epidemiological review of retinoblastoma in Omani children

aim?To describe the epidemiology of retinoblastoma (RB) in Omani children. method?The National Cancer Registry, hospital records, and treatment abroad registers were reviewed to identify the characteristics of Omani children diagnosed with RB between 1990 and 2002. results?Twenty-nine children (12 male and 17 female) were diagnosed with RB. The age-adjusted incidence was 4.04/million/year in children <15 years and 8.33/million/year in children <5 years. The mean age at diagnosis was 32.2 months (33.8 months for unilateral RB and 13.2 months for bilateral RB). 75% had unilateral tumors and 25% had bilateral tumors. The five-year survival rate for RB was 89%. None of the patients had a family history of RB. conclusion?The incidence of RB in Oman is at par with other countries. A definite female preponderance exists in the Omani population. The proportion of unilateral RB cases is unusually high among Omani children. The five-year survival rate is almost at par with that reported in the West. Genetic studies and further longitudinal studies of surviving RB cases could further enhance the knowledge of the epidemiology of RB in Oman.     

视网膜母细胞瘤组织中HPV-DNA表达的研究

目的:研究我国视网膜母细胞瘤(retinoblastoma,RB)中HPV-DNA表达情况,为进一步揭示HPV在散发性RB中作用提供初步依据。方法:收集22例散发性RB患者新鲜肿瘤组织标本,应用PCR方法及引物MY09/11检测肿瘤组织中HPV-DNA表达情况。结果:选取22例RB肿瘤标本中7例HPV-DNA阳性(32%),均为单眼散发患者(包括男4例,女3例),2例双眼散发患者均为阴性。结论:HPV可能是我国散发性RB发病因素之一,但其明确作用及机制尚待进一步研究。     

The incidence of retinoblastoma.

Data from the Third National Cancer Survey indicate that the annual incidence of retinoblastoma in the United States is 11.0 new cases per million children under the age of 5 years. In response to a reported excess of mortality among blacks, rates were computed by race. There was a rate of 10.8 cases per million children for the whites compared to 9.8 cases per million for the blacks. Among the total of 61 newly diagnosed cases reported among residents of the survey area, the 50 unilateral cases occurred in 24 boys and 26 girls, whereas the 11 bilateral cases occurred in nine girls and only two boys. The reasons for a female preponderance among the bilateral cases remain unclear.     

Metachronous tumor development in unilateral retinoblastoma

PURPOSE: A series of 205 retinoblastoma (RB) patients referred to the Department of Ophthalmology at the University of Siena (Italy) was evaluated in order to assess the proportion of unilateral cases later developing tumors in the companion eye ("metachronous" bilateral retinobastoma) (MBRB). METHODS: The total number of unilaterally affected patients developing tumors in the fellow eye was recorded and the risk factors assessed for the development of asynchronous bilateral retinoblastoma, i.e., family history, tumor multifocality and early age at diagnosis. RESULTS: Only two out of 133 (1.5%) unilateral retinoblastoma patients in our series could be considered affected by MBRB. CONCLUSIONS: The incidence of MBRB in our series was negligible (1.5% of all unilateral cases) compared to other reports. None of the reported risk factors for the development of tumors in the fellow eye was relevant in the present series. Although close follow-up of some unilateral cases is still recommended, thorough examination of the fellow eye, to search for lesions in the peripheral retina, is essential in all cases of unilateral RB. MBRB may be a distinctive clinical entity with specific clinical, genetic and prognostic features. However, all these aspects need to be better investigated in larger series.     

Prevalence and distribution of active trachoma in children of less than five years of age in trachoma endemic regions of Oman in 2005

BACKGROUND: Oman aims to achieve "Elimination of Blinding Trachoma" by 2010. For accreditation purposes, a trachoma survey was conducted in Oman in 2005, targeting children younger than five years. It was conducted in twenty wilayats (districts) of three trachoma endemic regions. The Omani children were surveyed at health institutions during a 'Polio Supplementary Immunization Campaign.' The authors present the outcome of this survey and recommend policies for trachoma control in the study area. METHODS: Eye health care supervisors examined Omani children sequentially in health centers. However, the timings and days of visit to these health centers were selected randomly. The presence of trachoma follicular (TF) was noted in the tarsal area. The prevalence of TF was calculated and its distribution was mapped. RESULTS: The coverage for the immunization of children of less than five years of age residing in the study area was greater than 97%. For trachoma evaluation, 4,205 children were examined. The prevalence of TF in children of less than five years of age was 0.59% (95% CI; 0.40-0.88). Sumail, Hamra and Izki wilayats of Dhakhiliya region and Barka and Al Awabi Wilayats of South Batinah region had a prevalence of TF greater than 1%. No wilayat of North Sharqiya region had > or =1% TF. The gender variation in TF was not significant. (RR = 0.97 [95% CI 0.46-2.05]). CONCLUSIONS: All the Wilayats of trachoma endemic regions of Oman seem to have a prevalence of TF lesser than 5%. The data on TF in children aged between six and ten will enable us to determine whether Oman has achieved the Ultimate Intervention Goals (UIGs) for the provision of antibiotic treatment for acute infection (the "A" component of the SAFE strategy for the "Elimination of Blinding Trachoma" for the year 2005). Such initiatives of trachoma screening during a supplementary vaccination campaign could prove a cost-effective approach for determining the trachoma status of a country.     

Mutational analysis of the RB1 gene in Indian patients with retinoblastoma

Twenty-one probands, twelve with bilateral and nine with unilateral retinoblastoma, were screened for mutations in the RB1 gene using genomic DNA from peripheral blood leukocytes as well as tumors. Amplification of individual exons and flanking regions of the RB1 gene were carried out, followed by direct sequencing of the amplified products. Sequences of affected individuals were compared with those of controls. Mutations were identified in seven patients, five with bilateral and two with unilateral retinoblastoma. Six out of seven mutations involved the formation of premature termination codons by means of single base substitutions (2), frameshifts due to splice-site mutations (2), or deletion and duplication (2). One missense mutation was identified. Of the remaining fourteen patients, seven with bilateral disease had no mutations in peripheral blood (7 cases) or tumors (3/7 cases). Analysis of the peripheral blood of seven patients with unilateral disease also showed no mutations. Mutations were detected in about one-third of the cases, suggesting that hemizygous deletions at the RB1 locus or mutations outside the coding regions of RB1 may be responsible for the disease in the remaining patients.     

Biometry data from caucasian and african-american cataractous pediatric eyes

PURPOSE: To report the biometry data of pediatric cataractous eyes (randomly selected single eye in bilateral cases; cataractous eye in unilateral cases) and to compare the biometry data of the unilateral cataractous eye with the data of the corresponding noncataractous fellow eye. METHODS: The study was a chart review/analysis of immersion A-scan biometry measurements, excluding traumatic cataract or lens subluxation. RESULTS: Three hundred ten eyes were examined at surgery. The mean age was 45.30 +/- 48.10 months; globe axial length (AL), 20.52 +/- 2.87 mm; anterior chamber depth (ACD), 3.29 +/- 0.60 mm; and lens thickness (LT), 3.62 +/- 0.86 mm. During the first 6 months of life, AL increased 0.62 mm/mo, 0.19 mm/mo from 6 to 18 months, and 0.01 mm/mo during 18 months to 18 years of age. The girls had shorter ALs than did the boys (P = 0.090), and the African-American subjects had longer ALs than did the Caucasians (P < 0.001). Eyes with unilateral cataract had shorter ALs than those with bilateral cataracts before 60 months of age, but had longer ALs than the eyes with bilateral cataracts after 60 months of age. Eyes of the female subjects had shallower ACDs than those of male subjects (P = 0.026). Eyes with unilateral cataract had shallower ACDs than those of eyes with bilateral cataracts (P = 0.001). In the children >5 years of age, LT was significantly greater in eyes with unilateral cataract than in those with bilateral cataract. AL of the unilateral cataractous eye was significantly shorter than that of the fellow noncataractous eye before 6 months of age (P = 0.001). CONCLUSIONS: This study begins to lay the groundwork for calculating pediatric IOL power in cataractous eyes by using pediatric ocular measurements.     

Genetic diagnosis of retinoblastoma by a combination of fluorescence in situ hybridization and restriction fragment length polymorphism

PURPOSE: It is important to exclude germ line mutation in cases of unilateral retinoblastoma(RB) to estimate hereditary or possible secondary cancer. We investigated whether genetic diagnosis is feasible in a health check screening program. METHODS: Five patients with RB had surgery for enucleation in Keio University Hospital. Tumor cells from enucleated eyes and lymphocytes representing systemic cells were collected and analyzed genetically by fluorescence in situ hybridization(FISH) and restriction fragment length polymorphism (RFLP). RESULTS: One out of three unilateral RB cases could be diagnosed as non-hereditary by the finding of no copies of the RB gene in the tumor cells using the FISH method and no signal in the RFLP method. A decrease of signal in tumor cells to less than 50% in the RFLP method was observed in another case of unilateral RB that seemed to be non-hereditary, but the case ultimately could not be diagnosed as non-hereditary because polycopies were found in the FISH method. No abnormality in tumor cells could be found in another unilateral case or in systemic cells of two bilateral cases. CONCLUSION: A combination of FISH and RFLP methods can be used to diagnose some cases of RB as non-hereditary.     

Long-term visual acuity and its predictors after surgery for congenital cataract: findings of the British congenital cataract study

PURPOSE: To report long-term postoperative visual acuity in a nationally representative group of children with congenital/infantile cataract and to investigate the factors associated with poor vision. METHODS: All children aged less than 16 years in the United Kingdom who had newly diagnosed congenital/infantile cataract in a 12-month period during 1995-1996 (the British Congenital/infantile Cataract Study) were traced through their managing ophthalmologists. Outcome data were collected at least 6 years after diagnosis, by using specifically designed questionnaires. Ordinal regression analysis identified factors associated with postoperative acuity. RESULTS: Of 153 children who had surgery, complete data were available in 122 (85%). Median age at follow-up was 7 and 6.91 years, respectively, for bilateral and unilateral disease. Median age at surgery was 4.57 months in bilateral and 2.99 months in unilateral cases, with 40% and 45%, respectively, of children operated on by 3 months. Median (range) postoperative acuity was 6/18 (6/5, no perception of light) in bilateral and 6/60 (6/5, no perception of light) in unilateral disease. Poor compliance with occlusion was the factor most strongly associated with poorer acuity in both unilateral and bilateral disease: the odds of worse vision in unilateral cataract were 7.92 times greater with <50% versus 100% compliance (95% CI 1.68-37.26). In bilateral disease, odds of worse vision were reduced with each month of decreasing age at surgery (0.98, 95% CI 0.94-0.99), but increased by the presence of additional medical conditions (3.53, 95% CI 1.08-11.44) and the presence of postoperative ocular complications (2.94, 95% CI 1.38-6.51). CONCLUSIONS: These findings support a secular improvement in postoperative acuity in bilateral, and to a lesser extent, unilateral disease. Nevertheless early detection of congenital cataract through effective newborn screening and improving concordance with occlusion both remain priorities. Further improvements in outcomes in unilateral disease are necessary before parents can be advised universally that treatment will achieve a functionally useful "spare" eye.     

Fine needle aspiration biopsy (FNAB) for retinoblastoma

PURPOSE: To determine the incidence of diagnostic fine needle aspiration biopsy (FNAB) in eyes with retinoblastoma (RB) as well as its indications and potential complications. METHODS: A retrospective study by survey was designed and a questionnaire inquiring on FNAB use in RB diagnosis during the past 15 years was submitted to 12 high-volume ocular oncology clinics. RESULTS: A total of 3,651 patients with RB have been diagnosed and treated in 12 clinics since 1985. During the same period, eight biopsies were obtained for diagnostic purposes and six of these proved to be RB by cytology; the other two showed inflammatory cells and benign retinal cells. The median age for the biopsied patients was 46 months; 6 of the biopsied children were older than 4 years of age. The average age at the time of biopsy was 46 months. Most of the cases were biopsied with clinical diagnosis of uveitis/endophthalmitis through the limbus and pars plana with 25- and 27-gauge needles. Five of six cases of RB had enucleation and one patient had cryotherapy and I-125 brachytherapy after FNAB. The average follow-up time for biopsy-proven RB cases was 10.8 years with no recurrent disease. CONCLUSION: The results of this survey suggest that FNAB indication for RB diagnosis is rare; the majority of cases can be diagnosed and treated by ocular oncologists without invasive procedures.     

The prevalence of trachomatous trichiasis in Oman (Oman eye study 2005)

PURPOSE: 1. To estimate the prevalence and identify the determinants of Trachomatous Trichiasis (TT) among the > 40 years old Omani population. 2. To compare the results of the present study to those of the survey conducted in 1996 and propose public health policies for eye care in Oman. METHODS: Ophthalmologists randomly selected 75 houses in 24 clusters. The visual status per eye was noted. The anterior segment of the eye was examined to detect TT, using the WHO simplified grading. Frequencies, the age sex standardized prevalence and their 95% Confidence Intervals (unadjusted for clustering) were calculated and the numbers of people with TT in the population were estimated. RESULTS: Persons examined numbered 2,339. The prevalence of TT among the > 40 years old Omani population was 4.14% (CI 95% 3.3 to 4.9). The gender variation [OR = 1.51 (CI 95% 1.01 to 2.37)] and regional variation of TT was significant (p < 0.001). The standardized prevalence of TT in the > 40 years old Omani population had declined from 7.25% in 1996 to 3.96% in 2005. Predictors of TT were female gender, and age > 60 years. CONCLUSIONS: Trichiasis is still a public health problem in Oman. The prevalence is higher than the "< 1 TT case per 1000" target set for the "Ultimate Intervention Goals" for the "Elimination of Blinding Trachoma." The TT surgery rate in Oman should be increased to reach this goal. The underlying causes of low coverage should be identified and addressed through a program approach.     

Second malignant neoplasms in children with retinoblastoma: the St. Jude Children's Research Hospital experience

A retrospective review of 172 children with primary diagnosis of retinoblastoma (rb) was completed at St. Jude Children's Research Hospital to evaluate the incidence of second malignant neoplasm (smn) development. Sixty-five patients presented with bilateral rb and 107 with unilateral rb. During follow-up, which ranged from 6 to 340 months (median = 170 months), 6 children (3.5%) developed smn. All patients who developed smn presented with bilateral disease (n = 5) or asynchronous bilateral disease (n = 1); two patients had a family history of rb. All had received irradiation. Four patients developed osteogenic sarcoma within this irradiated volume, one developed a basal cell carcinoma in the temporal region (within the irradiation field), and one was diagnosed with a lower extremity Ewing's sarcoma. Time to development of smn ranged from 125 to 194 months post-irradiation. Initial irradiation total dose ranged between 32 and 45±76 Gy. Three patients were treated with anterior field irradiation and three received lens-sparing techniques (anterior/lateral n = 2, lateral n = 1). At last follow-up, 4/6 patients had died of smn. The crude incidence is 3.5% with an estimation of risk using the density method of 24% at 20 years for smn development. The specifics of the treatment associated with these second malignancies and the possible reasons for the reported incidence of smn will be discussed.     

Incidence of presumed cytomegalovirus retinitis in HIV-infected pediatric patients.

INTRODUCTION: Large population studies of adult patients suggest an incidence of cytomegalovirus (CMV) retinitis as high as 19% to 20% as a late complication of adult HIV infection. We conducted this prospective study of a large cohort of HIV-infected children to determine the incidence of CMV retinitis in HIV-infected children. METHODS: From January 1984 to August 1997, 173 HIV-infected children were followed up for an average of 55.3 months (13-164 months). The patients were seen in the Department of Pediatrics at least once every 6 months. Ophthalmologic examinations were initiated when a patient's CD4 count dropped below 50 or sooner if required for ophthalmologic or other indications. Ophthalmologic examination was then repeated every 6 months. RESULTS: A total of 116 (67%) of 173 patients underwent ophthalmologic examination. Four (3.4%) of 116 patients had CMV retinitis at a mean time of 17.3 months (8-38 months) after their CD4 counts dropped below 20. None of the 4 patients with CMV retinitis had subjective visual complaints despite advanced retinitis. Three patients had bilateral and 1 patient had unilateral CMV retinitis. CONCLUSIONS: CMV retinitis occurred infrequently in HIV-infected pediatric patients and was diagnosed only in patients with a CD4 count below 20. Routine ophthalmologic screening examinations may not be necessary in pediatric patients until the CD4 count is below 20. Because children may not complain of decreased vision, at-risk children should undergo frequent ophthalmologic examination.     

Episcleritis in childhood

OBJECTIVE: To describe the characteristics and systemic disease associations of episcleritis in childhood. DESIGN: Retrospective, observational case series. PARTICIPANTS: Twelve children diagnosed with episcleritis between July 1981 and June 1998. METHODS/TESTING: Complete eye and systemic evaluations. MAIN OUTCOME MEASURES: Characteristics of episcleritis and presence and nature of concurrent systemic disease. RESULTS: The 12 children (10 boys and 2 girls) ranged in age from 13 months to 16 years. Five children had bilateral simple episcleritis, one had bilateral nodular episcleritis, and six had unilateral simple episcleritis. The eye examination was otherwise normal and recovery was uneventful in all cases. Six of the nine children older than 5 years of age had one of the following rheumatologic diseases: systemic lupus erythematosus, juvenile rheumatoid arthritis, spondyloarthropathy, inflammatory bowel disease, rheumatic fever, or polyarteritis nodosa. All three children younger than 5 years of age had simple episcleritis, an antecedent viral illness, and presented within 2 months of each other. CONCLUSIONS: Episcleritis is a rare occurrence in childhood, especially in children younger than 5 years of age. In older children, it is frequently associated with rheumatologic disease.     

早期视网膜母细胞瘤激光光凝治疗效果

目的总结早期视网膜母细胞瘤激光光凝治疗的初步疗效。方法回顾性病例研究。收集2012年5月至2012年8月4例（4眼）在我科确诊为早期视网膜母细胞瘤（RB）的患儿,住院且行局部激光光凝治疗,随访6~12个月。4例患儿中男3例,女1例。就诊年龄最小2个月,最大1岁。其中1例有家族史,其余3例为散发病例。4例肿瘤距离黄斑>3.0 mm,距离视神经>1.5 mm,均没有玻璃体或视网膜下的种植,肿瘤直径均≤3.0 mm。结果4例患儿至随访期末肿瘤呈退缩模式。结论单病灶早期RB可单独使用局部疗法,激光是有效的局部治疗方法。     

The Prevalence of Trachomatous Trichiasis in Oman (Oman Eye Study 2005)

Purpose: 1. To estimate the prevalence and identify the determinants of Trachomatous Trichiasis (TT) among the > 40 years old Omani population. 2. To compare the results of the present study to those of the survey conducted in 1996 and propose public health policies for eye care in Oman. Methods: Ophthalmologists randomly selected 75 houses in 24 clusters. The visual status per eye was noted. The anterior segment of the eye was examined to detect TT, using the WHO simplified grading. Frequencies, the age sex standardized prevalence and their 95% Confidence Intervals (unadjusted for clustering) were calculated and the numbers of people with TT in the population were estimated. Results: Persons examined numbered 2,339. The prevalence of TT among the > 40 years old Omani population was 4.14% (CI 95% 3.3 to 4.9). The gender variation [OR = 1.51 (CI 95% 1.01 to 2.37)] and regional variation of TT was significant (p < 0.001). The standardized prevalence of TT in the > 40 years old Omani population had declined from 7.25% in 1996 to 3.96% in 2005. Predictors of TT were female gender, and age > 60 years. Conclusions: Trichiasis is still a public health problem in Oman. The prevalence is higher than the “< 1 TT case per 1000” target set for the “Ultimate Intervention Goals” for the “Elimination of Blinding Trachoma.” The TT surgery rate in Oman should be increased to reach this goal. The underlying causes of low coverage should be identified and addressed through a program approach.     

Hereditary Diffuse Infiltrating Retinoblastoma

Retinoblastoma is one of the most common childhood cancers. The diffuse infiltrating retinoblastoma is a rare subtype of this neoplasm. The majority of cases of diffuse infiltrating retinoblastoma are unilateral and occur sporadically. Herein we report on a family with three children affected by retinoblastoma, among them one girl with diffuse infiltrating retinoblastoma. This girl was diagnosed at the age of 8 years with a unilateral diffuse infiltrating retinoblastoma. By contrast, the two brothers became clinically apparent in the first 2 years of life with bilateral retinoblastoma. The parents were clinically unremarkable. Genetic analysis of RB1 gene was performed. The girl with diffuse infiltrating RB was found to be heterozygous for an oncogenic mutation in the RB1 gene that was also carried by both brothers and the father of the family. These results show that diffuse infiltrating retinoblastoma can develop on the background of a hereditary predisposition to retinoblastoma.     

Visual outcome and complications of bilateral intraocular lens implantation in children

PURPOSE: To determine the safety and efficacy of bilateral intraocular lens (IOL) implantation in children. SETTING: Tertiary referral pediatric ophthalmology department. METHODS: This retrospective study comprised 13 children (26 eyes) who had bilateral cataract surgery with IOL implantation. Patients were divided into 2 groups: congenital cases, diagnosed during the first year of life, and developmental cases, diagnosed after 1 year of age. All patients had small incision phacoemulsification with primary implantation of a poly(methyl methacrylate) or a foldable acrylic IOL. Primary posterior capsulotomy was performed in 16 eyes (61.5%). RESULTS: Age at surgery ranged from 1 week to just under 8 years. Seven patients (53.8%) had a systemic diagnosis: Down's syndrome (n = 4); developmental delay or cerebral atrophy (n = 3). Five children with systemic problems could not cooperate with formal vision testing; 2 could fix and follow bilaterally, and 3 had central, steady, and maintained vision bilaterally. In the congenital group, 37.5% of eyes attained a visual acuity of 20/20 and 87.5%, 20/120 or better. In the developmental group, formal vision testing was possible in 4 children. Five eyes (83.3%) attained a visual acuity of 20/40 or better. Thirteen eyes (50.0%) required posterior capsulotomy. Primary posterior capsulotomy reduced the incidence of posterior capsule opacification (PCO), but there was no correlation between PCO and IOL material. One patient developed glaucoma bilaterally. CONCLUSION: Bilateral IOL implantation was safe and produced good visual results in children of all ages with bilateral cataract.     

Congenital and infantile cataract in the United Kingdom: underlying or associated factors. British Congenital Cataract Interest Group

PURPOSE: Prevention of visual impairment and blindness in childhood due to congenital and infantile cataract is an important international goal. Preventive strategies require information about etiology that is currently unavailable for many regions of the world. From a national epidemiologic study, the underlying or associated factors in newly diagnosed cases of congenital or infantile cataract in the United Kingdom are reported, and the implications for future etiological research are discussed. METHODS: All children with congenital or infantile cataract newly diagnosed during 1 year in the United Kingdom were ascertained independently through two national active surveillance schemes comprising ophthalmologists and pediatricians, respectively. Detailed information about cases, including disease causes, was collected from reporting clinicians using standard questionnaires. RESULTS: Of 243 children with newly diagnosed congenital or infantile cataract, 160 (66%) had bilateral disease. Isolated cataract was more common in bilateral than unilateral cases (61% versus 47%, P = 0.05) as was cataract associated with a systemic disorder (25% versus 6%, P < 0.001). Conversely, cataract with associated ocular anomalies was more common in unilateral than bilateral cases (47% versus 14%, P < 0.001). No underlying or associated risk factors for cataract could be identified in 92% of unilateral and 38% of bilateral cases, although putative prenatal and perinatal risk factors were reported in a proportion of these idiopathic cases. Hereditary disease was associated with 56% of bilateral but only 6% of unilateral cases. Prenatal infections and other systemic factors were reported in only 6% of bilateral and 2% of unilateral cases. CONCLUSIONS: Given the high proportion of idiopathic congenital and infantile cataract, the scope for primary prevention in the United Kingdom is currently limited. There is a need for further etiological research, to examine the roles of environmental and genetic risk factors for idiopathic cataract.     

Outcome of lens aspiration and intraocular lens implantation in children aged 5 years and under

AIMS: To determine the visual outcome and complications of lens aspiration with intraocular lens implantation in children aged 5 years and under. METHODS: The hospital notes of all children aged 5 years and under, who had undergone lens aspiration with intraocular lens implantation between January 1994 and September 1998, and for whom follow up data of at least 1 year were available, were reviewed. RESULTS: Of 50 children who underwent surgery, 45 were eligible based on the follow up criteria. 34 children had bilateral cataracts and, of these, 30 had surgery on both eyes. Cataract was unilateral in 11 cases; thus, 75 eyes of 45 children had surgery. Cataracts were congenital in 28 cases, juvenile in 16, and traumatic in one case. The median age at surgery was 39 months (range 11-70 months). Follow up ranged from 12-64 months (median 36 months). Of 34 children with bilateral disease, 25 (73.5%) had a final best corrected visual acuity of 6/12 or better, while seven (20.5%) achieved 6/18 or less; in one child the vision improved from UCUSUM to CSM but another, who had only one eye operated on, was unable to fix or follow with this eye preoperatively or 2 years postoperatively. Of 11 children with unilateral cataract, five (45.5%) had a final best corrected visual of 6/12 or better, and six (54.5%) 6/18 or less. A mild fibrinous uveitis occurred in 20 (28.2%) eyes in the immediate postoperative period, but resolved with topical steroids. One child had a vitreous wick postoperatively requiring surgical division. Glaucoma, endophthalmitis, or retinal detachment have not been observed so far in any patient postoperatively. CONCLUSION: From this series the authors suggest that, in children aged 5 years and under, lens aspiration with intraocular lens implantation is a safe procedure, with a good visual outcome in the short term. Further studies are needed to investigate these outcomes in the long term.