Visual acuity after iridectomy or aspiration for congenital cataract: Experimental and clinical studies.

Studies with a camera and a model eye showed that the image produced by peripheral light rays is inferior to the image produced by paraxial rays. In a retrospective clinical study, we determined the best corrected visual acuity in 33 patients (52 eyes) who had had iridectomy (group I) or aspiration (group II) or both for central cataracts. Vision was significantly better (p less than 0.01) in group II than in group I, and postoperative complications of aspiration were minimal. Some patients had unilateral amblyopia or pendular nystagmus. We conclude that if vision is to be improved with a single procedure, aspiration - not optical iridectomy - is indicated. We could not identify any factors in early infancy that would have predicted which patients with congenital central cataracts required early surgery.