Posterior chamber intraocular lenses have numerous advantages over iris-supported lenses and many types of anterior chamber lenses; therefore, the implantation of sutured posterior chamber lenses in the absence of a lens capsule during penetrating keratoplasty has become more common. Suture fixation of the lens implant may be achieved by either 1) sewing the optic or haptics to the iris, or 2) sewing the haptics in the ciliary sulcus using transscleral sutures. In the case of the iris-suture technique, the implant acquires its stability mainly from the fixation sutures, but to some degree, placement of the haptics in the ciliary sulcus may enhance stability. In the case of the scleral fixation technique, implant stability is derived from placement of the haptics in the ciliary sulcus and the transsscleral sutures. Several variations upon these two basic suture fixation techniques currently exist, each with its own putative advantages and disadvantages. The different methods are schematically reviewed with diagrams and the comparative benefits and deficits are discussed.