AIM:To evaluate the efficacy and safety of two different surgical techniques on congenital cataract on children.METHODS:Twenty-two children (1-3 years old) with congenital cataract were randomly divided into two groups (group A and group B).With group A (10 patients,20 eyes),we applied 23-gauge (23G) trans corneal limbus vitrectomy system to complete lens cortex gettering,posterior capsulotomy and anterior vitrectomy;With group B (12 patients,24 eyes),we used the phacoemulsification I/A to complete lens cortex gettering,and performed anterior vitrectomy with anterior vitreous cutting instrument.After that,the differences in intraoperative and postoperative complications between two groups were compared.RESULTS:In group A,the width of corneal limbal incision was 0.6mm,the incision was self-sealing,and the anterior chamber was stable and iris did not prolapse during the surgery.In group B,the width of corneal limbal incision was 3mm,anterior chamber was unstable and intraoperative iris prolapse occurred in 14 eyes (58%).And the incision need to be stitched up after surgery.In the postoperative follow-up of 6-24 months (an average of 14 months),we found that corneal neovascularization did not occur in group A,while in group B,corneal neovascularization occurred in four eyes (17%);Other complications,such as posterior capsular opacification,retinal detachment,glaucoma,hypotony or endophthalmitis did not occur in either group.CONCLUSION:The 23G trans corneal limbus vitrectomy system used in pediatric cataract surgery is safer and more effective than phacoemulsification I/A.It is promising in treatment of congenital cataract on children.