Major problems in pediatric cataract patients include noncompliance with contact lenses resulting in amblyopia. Advances in intraocular cataract surgery have provided a better environment to perform intraocular lens (IOL) implantation in children. We prospectively analyzed the results of 34 consecutive pediatric patients who underwent cataract removal and insertion of an IOL. Operative technique performed was posterior scleral beveled or frown incision and IOL endocapsular fixation. Subgroups included 10 eyes with traumatic cataract, and 24 eyes with developmental cataracts. Six patients had bilateral IOLs. Data presented in each subgroup included initial and final visual acuity, age, sex, type of cataract, A and B scan biometry, early and late postoperative complications, time of YAG capsulotomy, postoperative refractive correction, and state of binocular vision. Preoperative visual acuity ranged from 20/70 to light perception. The success rate for postoperative visual acuity of 20/40 or better occurred in 29 of 34 eyes, or 85.3%. In the traumatic cataracts, 8 of 10 eyes (80%) obtained 20/40 vision or better. In developmental cataracts, 21 of 24 eyes (88%) achieved visual acuity of 20/40 or better. Amblyopia (three patients) or macular scar (two patients) accounted for reduced visual acuity in the five eyes with vision less than 20/40. Early complications included posterior synechiae and lens deposits. The primary late complication was opacification of the posterior capsule in 18 of 34 eyes. The average time for YAG capsulotomy post-cataract removal was 17 months. None of the 28 patients (34 eyes) developed glaucoma, IOL dislocation, or other significant postoperative problems related to IOL insertion.(ABSTRACT TRUNCATED AT 250 WORDS)