Comparison of Contact Lens and Intraocular Lens Correction of Monocular Aphakia During Infancy

Abstract

Intraocular lens (IOL) implantation at the time of cataract surgery is considered by many to be the standard of care for children 2 years of age or older in the United States.^1,2 In some developing countries, IOLs are used almost exclusively as the primary optical correction for children following cataract surgery.^3-5 In addition to its convenience, IOL implantation during childhood may be associated with better visual outcomes.⁶ However, when IOLs are implanted during early infancy, these potential advantages are offset by a higher incidence of intraoperative and postoperative adverse events.^7-9 Additional intraocular surgical procedures are often required to treat these adverse events, which are associated with risks, costs, and parental stress.^10,11 Furthermore, the rapid and somewhat unpredictable growth of infant eyes makes it difficult to select the ideal IOL power to implant.^12,13 Although it is generally agreed that cataract surgery during early infancy is associated with the best visual outcomes,^14-16 it remains undetermined whether primary IOL implantation is advisable in this age group.