A retrospective study of twenty patients with congenital cataracts is described. Eleven of these were bilateral and nine were unilateral cataract cases. Twelve patients had cataract extractions with an anterior vitrectomy; of these, six were unilateral and six were bilateral. The surgeries varied in time from one week to four years after birth. The remaining eight patients were either poor surgical risks or waiting for surgery. All of the post-surgical cataract patients were then fit with a Bausch and Lomb Silsoft lens. Five were successful as deemed by continual wear of a time period of no less than two years. The most common factor in success was parent compliance, understanding and ability to insert and remove the contact lenses. Variable patching regimens were undertaken. Patching generally began with one hour each day while wearing the contact lens. If an eye turn was noticed or visual acuities markedly decreased, this amount was increased to approximately 2-3 hours. This step-wise adjustment continued until a maximum of nine hours was attained. All of the unilateral aphakic patients, including those successful with contact lenses, exhibited some amount of amblyopia and all but one exhibited a lateral tropia and/or a vertical tropia after therapy. Two of the bilateral aphakic patients were without amblyopia or a manifest strabismus.
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