Management of monocular congenital cataracts

Monocular congenital cataracts have been treated for the past two decades w ith early surgery, contact lens correction and patching of the unaffected e ye. While an occasional patient has had a good visual outcome with this tre atment regiment, the majority end up being legally blind in the aphakic eye . Intraocular lenses (IOLs) are increasingly being used as an alternative m eans of optically correcting aphakia during infancy. A growing body of lite rature suggests that an IOL correction is associated with an improved visua l outcome and a relatively low incidence of post-operative complications. A monkey model has also been used to study the safety and feasibility of cor recting aphakia in neonates with IOLs. These studies have revealed that the visual outcome is as good if not better with an IOL correction. A multicen tre clinical trial, the Infant Aphakia Treatment Study (IATS), is being org anised in the United States to critically compare an IOL and contact lens c orrection for infantile aphakia.