In the absence of capsular support, iris/IOL fixation is an attractive alternative. Unfortunately, this form of IOL fixation frequently results in iris and pupillary distortion. Double-needle iris/IOL fixation is a technique that uses a suture needle to stretch, elevate, and fixate the iris to the cornea prior to fixation of the IOL. These maneuvers improve iris tissue sectility as well as access to the peripheral iris. With this technique and special attention during suturing, iris and pupillary distortion can be avoided.