OBJECTIVE To evaluate the efficacy of the use of intraocular lenses in the treatment of pediatric aphakia, according to postoperative visual acuity and refraction change. METHODS A total of 33 eyes in 27 children were studied. Children with either unilateral or bilateral cataracts were submitted to lensectomy surgery via pars plana, with intraocular lens implant, associated with primary posterior capsulectomy and anterior vitrectomy. The intraocular lenses were calculated for emmetropia in the first postoperative month. All children were less than six years old at the time of the surgery and had a 2.9 year average follow-up. They were divided into 3 groups. Group I (10 eyes), children with unilateral cataracts and under three years old at the time of the surgery; group II (11 eyes), children with unilateral cataracts and above three years old; group III (12 eyes), children with bilateral cataracts and above three years old at the time of the surgery. RESULTS On the last follow-up examination recorded visual acuity was equal to or above 20/40 in 85% of the eyes. A spherical equivalent close to emmetropia in the first postoperative month was obtained in 70% of the children of group III but only in 30% of group I. Regarding postoperative refraction variation, myopic shift was detected in 81.81% of the cases. The younger the children were when undergoing surgery, the greater the refractional alteration. CONCLUSIONS Despite the myopic shift that happens with the use of intraocular lenses in the treatment of pediatric aphakia in children under six years old, the visual result is very good and the residual refraction correction is easily performed. A more prolonged postoperative follow-up would be necessary for long-term evaluation of the results.