Persistent Challenges in Managing Monocular Deprivation Amblyopia: A Three-Decade Trend Analysis of Infant Unilateral Cataract Outcomes

Highlights

• Despite technical surgical advancements over the last 30 years, median visual acuity for infants with unilateral congenital cataracts remains poor, at approximately 20/500 (1.40 LogMAR).
• Surgical timing remains critical, but even with early intervention, the correlation with improved visual outcomes is statistically weak, suggesting biological limits to cortical recovery.
• The surgical burden is high: children with this condition undergo a median of five ophthalmic surgeries in their first decade of life.
• Complications are nearly universal, with 98% developing strabismus and 73% developing fusion maldevelopment nystagmus (FMN).

Background