A series of 614 primary intraocular lens (IOL) implantations performed at the Wilmer Institute during the past six years by two surgeons were reviewed. Progressive corneal endothelial cell loss and an increased rate of late-onset corneal edema were detected in the group with the Morcher (European) four-loop iris-clip Binkhorst IOLs. A higher rate of clinically significant cystoid macular edema (CME) developed in eyes with the American-manufactured four-loop Binkhorst lens, presumably from chronic iritis caused by contaminants on the IOLs. Our short-term results with the American-manufactured Shearing-type IOLs implanted at the time of extracapsular cataract extraction are encouraging, with 99% of cases achieving 20/40 vision or better, excluding those with known macular degeneration of amblyopia. A continued conservative approach to IOL implantation is recommended.