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To describe the results of foldable iris-fixated intraocular lens (IOL) implantation in children.Children with high bilateral or unilateral myopia who were intolerant of spectacle or contact lens correction were implanted with an iris-fixated foldable IOL and prospectively followed. We measured pre- and postoperative visual acuity, refraction, endothelial cell density (ECD) and National Eye Institute Visual Functioning Questionnaire-25.Eleven eyes of six children were implanted. Indications were high bilateral myopia in children with comorbid neurobehavioural disorders, high anisometropia and high myopic astigmatism. Mean preoperative spherical equivalent (SE) refraction was −14.6 dioptres (D) ± 4.2 SD. Mean follow-up was 15 months. Postoperative SE refraction was −2.40 D ± 2.40 SD. Corrected distance visual acuity (CDVA) improved from mean logMAR 0.84 ± 0.4 SD to postoperative 0.67 ± 0.34 SD (p = 0.005). CDVA was reduced because of coexistent ocular disorders and amblyopia. Vision-related quality of life (QOL) measures improved significantly. There were no intraoperative or postoperative serious complications.Foldable iris-fixated IOL insertion can give a significant improvement in vision and in vision-related QOL in a subset of paediatric patients with special refractive needs who are intolerant to conventional treatment. Long-term follow-up is required for monitoring of ECD.