Purpose: We compared the surgical outcomes and complications of conventional, sutured scleral fixation and flanged intra-scleral intraocular lens (IOL) fixation.Methods: We retrospectively analyzed the medical records of patients who underwent conventional, sutured scleral fixation or flanged intrascleral IOL fixation and who were then observed for more than 6 months. The best-corrected visual acuity (BCVA), operation time, spherical equivalent (SEQ), astigmatism, and postoperative complications were recorded up to 6 months after surgery.Results: Of sixty-nine enrolled eyes, 39 underwent conventional, sutured scleral fixation ("sutured" group) and 30 flanged intra-scleral IOL fixation ("sutureless" group). The operation time was significantly shorter in the sutureless group than in the sutured group (56.3 +/- 11.8 vs. 77.7 +/- 17.9 minutes, p < 0.001). In both groups, the BCVA and SEQ improved significantly at all visits after surgery compared to the baseline values p < 0.05). There was no between-group difference in BCVA, SEQ, astigmatism, or complications.Conclusions: Compared to conventional, sutured scleral fixation, flanged intrascleral IOL fixation afforded equivalent improve-ments in visual acuity but with a shorter surgical duration. Therefore, flanged intrascleral IOL fixation is a useful alternative to conventional, sutured scleral fixation.