The authors examined whether secondary IOL insertion is helpful in the successful treatment of monocular infantile cataracts. Eleven children were reviewed: eight with cataract extraction at one to four months of age and three at five to seven months of age. Secondary posterior chamber IOL insertion was undertaken at one to six years. Surgery for the one to four month infants resulted in obtaining visual acuities of ≥20/150 in 87.5%. One child developed stereopsis. Surgery for the five to seven month infants showed that poor visual acuity prior to IOL implantation remained poor. Contact lens and patching compliance markedly affected final visual acuity. The quality of aphakic correction and patching combined had the best effect. The authors conclude that cataract extraction with proper patching and use of aphakic contact lenses prior to four months of age with compliance for at least one year results in better outcomes / insertion of secondary IOLs will maintain vision.