Visual rehabilitation of patients with aniridia and progressive cataract is a challenging clinical problem. Reduced corneal transparency, limitations of iris support, and decreased zonular integrity may make extracapsular cataract surgery difficult. Four patients with familial aniridia had substantial visual improvement after successful extracapsular cataract extraction (ECCE) with implantation of capsular-fixated posterior chamber intraocular lenses (PC IOLs). In one patient, it was combined with trabeculectomy to treat chronic open-angle glaucoma. Posterior chamber IOLs can be safely implanted in the aniridic eye normalities in the anterior segment.