In this prospective study the clinical results using three different small optic IOLs are presented. The best results were achieved in those cases with an anterior capsule rim overlapping the entire optic periphery. In those cases with sulcus fixation, haptic in/out and optic in/out positions a higher percentage of capsule fibrosis (Soemmering's rings) was documented (sulcus fixation: 100%, haptic in/out position: 75%, optic in/out position: 65.5%, bag: 7.3%). The fibrosis developed because of contact between the anterior and the posterior capsule leaf. These cases also showed decentrations of the intraocular lens (IOL) more often (sulcus fixation: 50%, haptic in/out position: 75%, optic in/out position: 34.5%, bag: 31.7%). Only one patient was disturbed by glare and halo phenomenons. Cellular reactions on the lens surface were moderate in most cases. Differences specific to lens type were found between the three IOLs implanted. The clinical results were comparable to the results of other comprehensive IOL studies. Under certain indication small optic IOLs represent an alternative to flexible implants for small incision surgery.