Introduction The initial discouraging results of the use of contact lenses in monocular aphakia led a group of ophthalmic surgeons, primarily in Europe, and later in North and South America, to seek the solution to this problem by the use of intraocular lenses.6,8,10 The results of numerous series of cases treated with intraocular lenses have been reported.1,2,4Whereas during the past 10 years intraocular lens surgery has developed towards an even smaller risk for the patient, at the same time improvements in the design, manufacture, and techniques of fitting contact lenses have resulted in a contact lens which is better tolerated by patients. A need now exists to reevaluate and compare the 2 methods of treatment of monocular aphakics. The present study was stimulated by the controversy, between the advocates of each method of treatment, which occurred during the Symposium on Intraocular Implants at the Instituto Barraquer in