Functional Outcome of Monocular and Binocular Congenital Cataract Part I: Visual Acuity

Abstract

The charts of 25 patients (50 eyes) after binocular cataract surgery and 47 patients after unilateral cataract surgery were retrospectively reviewed. Every attempt was made to include only patients with documentation of dense cataract present since birth. Visual outcome was assessed as a factor of age at surgery and compliance with patching and optical correction after bilateral or unilateral cataract surgery. Best visual acuity was obtained in children who had early surgery, were compliant with therapy, and developed no ocular complications. Aphakic glaucoma was a complicating factor in 24% of bilateral cases and in 21% of unilateral cases. Strabismus was present in 50% of bilateral cases and in 96% of unilateral cases. We suggest that best results are achieved with early surgery followed by rapid optical correction and aggressive occlusion therapy. Maintenance occlusion is essential throughout childhood to cement visual gain. Early diagnosis and treatment of complications such as glaucoma can prevent visual loss in late childhood and facilitate better visual outcome.

• infantile cataracts
• visual acuity
• strabismus