Aim To report the results of paediatric cataract surgery with primary intraocular lens (IOL) implantation.

Methods Children with congenital or developmental cataract who underwent phacoaspiration with posterior chamber (PC) IOL implantation were retrospectively studied. Group A included children with polymethyl methacrylate, group B hydrophobic acrylic and group C silicone IOLs. Outcome measures were visual axis clarity, visual outcome and refractive changes.

Results There were 230 children (381 eyes) with the age ranging from 1 months to 15 years. Group A comprised 208, group B 144 and group C 29 eyes. Posterior capsule opacification was seen in 38/208 in group A and 21/144 in group B and 4/29 eyes in group C. The mean refractive error at 2 weeks, 1 year and 3 years after cataract surgery in the age group ≤2 years was +3.38±3.07 D (median +3.75 D), +1.72 D±3.19 (median +1 D) and −0.51 D±3.59 (median −0.5 D); in the age group >2–8 years +0.84±3.18 D (median+1.5 D), +0.27 D±3.14 (median +0.5 D) and −0.62 D±2.81(median −0.75D); and in the age group >8 years −0.44±1.73 D (median −0.5 D), −0.70±1.77 D (median −0.75 D) and −0.89 D±1.60 (median −0.75D) respectively. Children ≤2 years had a significant myopic shift (p<0.001). LogMAR visual acuity was ≥0.3 in 62.2% of eyes in bilateral and 30.90% in the unilateral group.

Conclusions Paediatric cataract surgery with primary PCIOL implantation is safe. Refractive changes and PCO are the main hurdles for achieving optimal visual outcome.