Thirty-five PhacoFlex foldable open-loop lenses with high-refractive silicone optics were evaluated. All lenses were implanted using a folding forceps and were fixated in the bag. Mean follow-up was 14 months. With adequate forceps, the lens may be inserted through a 3.2 mm incision, using a 3 mm long self-sealing sclerocorneal tunnel. With a well-centered 4 mm to 5 mm capsulorhexis opening, centration was very satisfactory. Moderate decentration occurred in two cases, one from a small, heavily shrinking capsulorhexis and the other from a poorly shaped capsulorhexis that captured the optic along its edge. Except in one case of combined cataract and filtering surgery, all optics were at a pronounced distance from the iris. Consequently, signs of iris chafing or iridocapsular synechias and cellular invasion were not seen. The optic typically exhibited a slight bluish tint and minute granular inclusions without clinical significance. Neither discoloration nor haze was present. Best visual acuity was 20/25 or better in all cases. The small wound required for insertion makes the PhacoFlex especially appropriate for clear corneal incision surgery. Attempts are being made to minimize the grainy appearance of the optic. Increasing the rigidity of the loops may be advantageous.