PURPOSE To ascertain the incidence of and factors related to retinal detachment (RD) after transscleral suture fixation of posterior chamber intraocular lenses (PC IOLs). SETTING Seoul National University Hospital, Seoul, Korea. METHODS Transscleral fixation of a PC IOL was performed in 122 eyes from January 1990 to December 1992. The occurrence of RD was noted and its association with preoperative, intraoperative, and postoperative factors evaluated. The type and location of retinal tears, extent of detachment, and need for reattachment surgery were recorded. Minimum follow-up was 12 months. RESULTS Six eyes (4.9%) developed RD, 5 in the primary implantation group (n = 62; unplanned posterior capsule rupture during extracapsular cataract extraction, IOL dislocation/subluxation) and 1 in the secondary implantation group (n = 60; aphakia after previous cataract surgery); the difference between groups was not statistically significant. The factors predisposing to RD were myopia greater than -1.0 diopter (P = .03) and postoperative vitreous hemorrhage (P = .001). There was no significant difference in the incidence of RD in eyes having transscleral fixation in either a primary or secondary procedure and those having secondary lens implantation using a different IOL type or surgery with no lens implanted. CONCLUSION The incidence of RD in patients having transscleral PC IOL fixation after vitreous loss was not significantly different from that in other studies not using transscleral PC IOL fixation with vitreous loss.