Despite progress in microsurgical treatment, pediatric cataracts still imply potential risks for pathological unilateral or bilateral visual and binocular development. Surgical approaches have changed fundamentally over the last 30 years which are directly associated with modifications in the postoperative care. Due to these parallel developments a continuous dynamic process arises between anterior segment surgeons and pediatric ophthalmologists so that only small case series exist which try to combine both subspecialties because until now it was not possible to gather enough experience with a single linear approach. The first article of this two part series will explain the variability of the disease and surgical approaches and the second part will try to convey a linear approach for the postoperative care.