Management of monocular infantile cataract is time-consuming, expensive, and tries the tolerance of parents as well as the patience of their child’s ophthalmologist. During the last 2 decades, many technical problems have been overcome with treatment associated with good vision for some children. Among those innovations was the introduction of extended-wear silicone elastomer and custom rigid-gas permeable contact lenses, which were a great improvement over aphakic spectacles. Nonetheless, there are problems with aphakic contact lenses including the cost of replacement and need for frequent replacement for reasons such as refractive error change, lens loss, parental stress managing the lens, and corneal injury. These reasons have made aphakic contact lenses in infancy appear not to be the final answer.