For infants with unilateral cataracts, cataract surgery performed before 2 months of age leads to better visual outcomes at 5 years compared to later surgery, according to a study. However, in bilateral cases, the timing of surgery within the first year does not significantly affect long-term vision.
The prospective registry study from the Pediatric Eye Disease Investigator Group followed 149 infants (203 eyes) who underwent lensectomy before their first birthday and were left aphakic.
Age at surgery did not impact long-term vision in children with bilateral cataracts, however children with unilateral surgery before 2 months had better average visual acuity (logMAR 0.79) compared to those operated on between 2 and 6 months (logMAR 1.13; P = 0.01). A greater proportion of bilaterally operated eyes achieved visual acuity better than 20/200 compared to unilateral cases, regardless of age at surgery.
Reference
Repka MX, Sutherland DR, Hatt SR, et al; Pediatric Eye Disease Investigator Group. Effects of Age at Surgery and Laterality of Cataract on Visual Acuity 5 years After Surgery in Infants Left Aphakic. Ophthalmology. 2025;S0161-6420(25)00393-8. doi: 10.1016/j.ophtha.2025.06.022. Epub ahead of print. PMID: 40582417.
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