Abstract Purpose: To evaluate surgical problems, postoperative complications, and visual results of secondary posterior chamber intraocular lens (IOL) implantation in children. Setting: L.V. Prasad Eye Institute, Hyderabad, India. Methods: A retrospective study was done of secondary IOL implantation in 27 children (35 eyes) who were not satisfied with aphakic glasses and were intolerant of or reluctant to use contact lenses. The extent of posterior capsular support was assessed prior to surgery. Additional surgical procedures were posterior synechiolysis (11 eyes), anterior vitrectomy (8 eyes), pupilloplasty (2 eyes), and membranectomy (2 eyes). Results: Postoperative complications included wound leak (1 eye), uveitis (5 eyes), peripheral anterior synechias (2 eyes), and retinal detachment (1 eye). Visual acuity improved or remained at the preoperative level in 34 eyes. Conclusion: Secondary posterior chamber IOL implantation is an effective optical modality for managing pediatric aphakia. Observation must continue to determine the long-term safety of the procedure.