Grating acuity development after early surgery for congenital unilateral cataract.

Longitudinal measures of grating acuity were obtained from 16 children after early surgery, optical correction, and occlusion therapy for congenital unilateral cataract. Compliance with contact lens wear and occlusion therapy was good in this population. Monocular grating acuities were obtained by preferential looking during months 1 through 15 and by an operant procedure during months 16 through 53. Grating acuities of normal eyes did not differ from those obtained in an age-matched normal population and showed no evidence of occlusion amblyopia. During the first year of life, grating acuities of aphakic eyes were typically within the normal range, but lagged behind normal development during years 2 through 4. These results suggest that early surgery is associated with favorable long-term visual results but does not, even with good compliance, completely eliminate deprivation amblyopia.