Secondary implantation of flexible, open loop anterior chamber IOLs was performed on 20 aphakic eyes between January 1990 and May 1992. In 3 cases anterior vitrectomy was necessary. No other complications were encountered during surgery. The patients were followed up for 4 months postoperatively. Seventeen eyes achieved a corrected visual acuity of 5/5 or better. Fourteen eyes achieved the same visual acuity as preoperatively, and 5 ended with an improved visual outcome. In one case the visual acuity became worse than preoperatively due to cystoid macular edema. No other serious postoperative complications occurred. The postoperative refraction was within 1 diopter of emmetropia in 16 eyes compared to the estimated (biometry) 19 eyes. We conclude that implantation of flexible open loop anterior chamber IOLs is a safe procedure in properly selected cases.