AIM:To observe the changes of axial length after second term intraocular lens(IOL) implantation in infants after congenital cataract extraction.METHODS: A consecutive case series of total 13 aphakic infants (22 eyes including 4 unilateral eyes), who had undergone IOL implantation surgeries at 2.5 years of age, were included. Patients were divided into 3 groups based on their ages at follow-ups: 3-year group, 4-year group and 5-year group. The axial lengths in each follow-up were measured. The changes of axial length were analyzed and compared with those of normal age-gender-matched children.RESULTS: The mean axial lengths from 3-year group to 5-year group were 22.41±1.75mm, 23.16±1.42mm and 23.73±1.37mm respectively.There was statistically significant difference compared with those of normal age-gender-matched children (P<0.05) .CONCLUSION: The axial length of young children, following second term IOL implantation at 2.5 years of age, was longer than normal children in the period of 5 years of age. 