We studied the two-year postoperative course of 46 eyes with transscleral ciliary sulcus fixation of a posterior chamber intraocular lens (sutured group) and 30 eyes with ciliary sulcus insertion of a posterior chamber intraocular lens as a secondary implantation (nonsutured group). The following items were evaluated: visual acuity, difference between preoperative predicted refraction (calculated by the SRK II formula) and final postoperative refraction, complications, corneal endothelial cell loss, and anterior chamber depth. In the nonsutured group, visual acuity was favorable in general and few complications were observed. In the sutured group, 16 eyes were followed for 2 years, and 12 (75%) of them achieved the same or better visual acuity than before surgery. In 4 (25%) of them visual acuity decreased compared with its preoperative status. In the sutured group, we analyzed 13 factors that might have been associated with poor postoperative visual acuity, and cystoid macular edema appeared to be most strongly related with worse final visual acuity than before surgery (p < 0.05).