Non-surgical factors in the correction of aphakia

72 unselected patients wearing aphakic spectacle correction were examined more than 6 months postoperatively. Approximately one third had poor adaptation in spite of satisfactory acuity. No correlation with age was found in the 60-85 year range. Binocularity appeared to play no part in adaptation but a significant sex difference was found, females predominating in the non-adapted group. Tests of eye movements showed defects in vestibulo-ocular suppression, smooth pursuit, and saccadic accuracy in the non-adapted group. This may indicate floccular dysfunction as a reason for failure to adapt to aphakic spectacles. This suggests the possibility of a useful preoperative assessment test to predict adaptation difficulties.