The optical performance of pseudophakic eyes were compared after implantation of spherical and aspheric IOLs in paediatric patients after cataract surgery. This randomised controlled trial included 40 eyes of 23 patients: 20 eyes in each group. Follow-up was over three to 15 months. No complications were reported from surgery. Refraction was 0.98 ±1.12D and 0.86 ±0.85D for the spherical and aspherical groups respectively which was not significant. Best corrected visual acuity was 0.32 ±0.19 log and 0.28 ±0.16 log for the spherical and aspherical groups respectively which was not significant. There was significantly lower total wave front aberration and spherical aberration in aspheric eyes. The findings support better visual performance with aspheric IOLs and the authors therefore recommend these for IOL surgery in children. Larger studies are still required to explore this further.