We reviewed the charts of 420 consecutive extracapsular cataract extraction cases in which the surgeon's primary intention was to implant a posterior chamber lens. Posterior chamber lens implantation was precluded in eight cases (1.9%) because of vitreous loss or capsule dehiscence. A visual acuity of 20/40 or better was achieved by 83.8% of patients. When nonoperative causes of poor vision were eliminated, this result was achieved by 96.7% of patients. The percentage of patients achieving 20/40 or better acuity decreased with increasing age but remained constant despite varying follow-up periods. The most common complication was opacification of the posterior capsule, occurring in 25.7%; 83.8% of the complications occurred during the first two postoperative years. We conclude that extracapsular cataract extraction with primary posterior chamber lens implantation is an efficient way to restore good vision after cataract formation and that the results appear to remain stable over time.