In 24 infants who underwent surgery for bilateral congenital cataracts, 29 eyes (60%) achieved visual acuities of 6/18 (20/60) or better and 13 (27%) had visual acuities of 6/60 (20/200) or worse. The best results occurred in patients who underwent surgery before they were 8 weeks old. Only one patient of the seven operated on after the age of 8 weeks achieved a visual acuity of better than 6/60 (20/200). These favorable visual outcomes were the result of early surgery, short intervals between operations on fellow eyes (48 hours or less), total bilateral occlusion between operations, careful postoperative monitoring with retinoscopy and visual-evoked potentials, and early correction of aphakia.