Although hydrogel extended-wear contact lenses (EWCLs) have been used extensively in the correction of aphakia in neonates, little is known about the effects of these lenses on infant corneas. Recent studies have demonstrated that long-term contact lenses can induce endothelial morphometric changes, including an increased coefficient of variation (CV) of mean endothelial cell area. Using wide-field specular microscopy, the authors studied 11 eyes of 10 patients, 1 to 3 years of age who, after lensectomy for congenital cataracts, wore EWCLs for the correction of aphakia. Except for two corneas in which increased pachometric readings and CV developed after repeated episodes of lens loss and inflammation, the EWCL were well tolerated and associated with few complications in this study.