Choice of surgical technique in the management of congenital cataract.

A group of patients with congenital cataracts which were operated by an aspiration technique was compared with a similarly aged group who were operated by a lensectomy technique. Of the 28 eyes in which the lens was aspirated, leaving the posterior capsule intact, nineteen required re-operation a total of 32 times to keep the pupillary area clear for refraction and accurate contact lens prescription. The re-operations were carried out during the first 18 months of life which are critical for visual development, and probably represent a substantial force in the genesis of the amblyopia which profoundly alters the visual prognosis in congenital cataract. The 23 eyes which were operated by lensectomy did not require further surgery; this indicates that, despite the possible risk of retinal detachment, lensectomy may be the best surgical technique for the avoidance of amblyopia in congenital cataract.