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Aims-To determine functional results after unilateral and bilateral cataract surgery in children with diVerent aphakic optical correction. Methods-In this retrospective study, we evaluated visual acuity and binocular vision in 107 children who underwent cataract surgery during the 10 year period from 1985 to 1995. Aphakia was corrected by an intracapsular intraocular lens (IOL), spectacles or contact lenses. Results-Mean visual acuity was >20/40 (<0.3 log MAR) with normal binocular vision in 58 children over 7 months of age operated on for bilateral cataracts. Pseudophakic eyes regained visual acuity >20/63 (<0.5 log MAR) more often (90%) than aphakic eyes (46%) (p<0.001). Binocular vision was also achieved more often after IOL implantation (p<0.001). Visual outcome of early bilateral cataracts was less satisfactory in children with abnormal foveolar function. For 49 children who had surgery for unilateral cataracts, prognosis was poor when surgery was performed before the age of 7 months. For cataract surgery in older children (>7 months) mean visual acuities were better with IOL implantation (p<0.05). Conclusion-Cataract surgery with unilateral and bilateral IOL implantation can provide a beneficial eVect on final visual outcome in children who are operated on before abnormal foveolar function develops.

Implantation of posterior chamber phakic IOLs is effective and predictable; however, long-term follow-up is needed.

Implantation of a phakic IOL in a highly myopic eye of a patient between 30 and 50 years of age can be considered an adequate technique with a lower risk for loss of BCVA than CLE.