Between August 12, 1982, and June 30, 1987, 233 consecutive eyes had posterior chamber intraocular lenses (PC IOLs) suture-fixated to the posterior aspect of the iris during penetrating keratoplasty (PKP). In all cases, insufficient capsular material was present to provide adequate fixation for the implant. Lenses were placed in 72 aphakic eyes as a secondary implant, and 159 lenses were placed after removal of another implant. Follow-up ranged from 1 year to 68 months with 59.5% of patients achieving visual acuity of 20/40 or better, and 74% of 20/80 or better. Suture-fixating a PC IOL to the iris offers multiple advantages over placement of an anterior chamber lens during PKP. The complication rate appears low, and long-term problems with glaucoma and recurrent corneal decompensation should be reduced.