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Purpose: To evaluate the visual outcome and long-term complications of intraocular lens implantation along with primary posterior capsulectomy & anterior vitrectomy in children with bilateral developmental cataract.</p> <p>Methods: This retrospective study was carried out on the 48 eyes of 24 children who had undergone cataract surgery under general anesthesia. Age range was 2 to 8 years. All patients underwent primary posterior capsulectomy, primary in-bag intraocular lens (IOL) implantation, irrigation-aspiration of lens debris, and anterior vitrectomy. At intervals of one week, one month, three months, and six months, every case was evaluated. After 6 months best corrected visual acuity was recorded and intraocular pressure, anterior chamber angle, optic disc, and peripheral retina were evaluated.</p> <p>Results: Postoperative best corrected visual acuity were 6/6 in 10.4% eyes, 6/9-6/18 in 56.3% and <6/18 in 33% eyes. Intra ocular pressures were found within normal limit (12 ± 2.09 mm of Hg) in all cases. Anterior chamber angle was normal in 44 eyes (91.7%). Peripheral retina and vitreous were normal in all cases. No significant Optic disc changes were noticed. The most common cause of decreased vision was amblyopia (79.2%) in the fellow eye due to delayed surgery.</p> <p>Conclusion: Amblyopia is the main cause of decreased visual recovery in children after cataract surgery. Surgical intervention in proper time results in good visual outcome