Secondary posterior chamber IOL implantation: Surgical techniques: 1. Capsular bag implantation. 2. Sulcus-sulcus fixation of IOL. 3. Trans-scleral fixation of IOL. 4. Iris fixation using McCannel sutures. Indications for secondary posterior chamber intraocular lens implantation in children are bilateral or unilateral pediatric aphakia resulting from: 1. Children undergoing pars plana lensectomy and vitrectomy at the time of primary surgery. 2. Inadequate support as a result of posterior capsule tears at primary surgery or damage to zonular apparatus or in congenital anomaly with ectopia lentis or spherophakia where zonular support is weak. 3. Aphakia in traumatic cataract. 4. Microphthalmia at time of primary cataract surgery (Axial length less than 17 mm) 5. Failure of contact lens or aphakic spectacles as a modality of visual rehabilitation in children who were younger than 2 years at the time of primary surgery and where the primary surgeon chose not to implant an IOL in the first setting. Most surgeons prefer PMMA single piece IOL for secondary IOL implantation. Recent evidence suggests that hydrophobic acrylic IOLs may be considered for secondary IOL implantation in children. Preferable optic size should be 6mm to 6.5 mm and over all diameters 12.5 to 13.0 mm. In case we consider scleral fixation we can use either special lenses with holes in haptic for scleral fixation or any single piece PMMA PCIOL with optic size (6.0 to 6.5 mm) and over all diameter 12.5 to 13.0 mm.