OBJECTIVE: To evaluate the efficiency and safety of iris retractor-assisted cataract surgery with modified scleral fixation for treating subluxated lenses. METHODS AND ANALYSIS: We developed a modified technique combining iris retractors with intrascleral intraocular lens (IOL) fixation for the treatment of moderate or severe lens subluxation due to non-progressive or progressive zonular defects. A retrospective case series study was conducted, including patients diagnosed with severe zonular dialysis who underwent this technique. Clinical data were collected and analyzed, including comprehensive ophthalmic examinations, anterior segment optical coherence tomography, surgical procedures, and outcome measures such as visual acuity and IOL positioning. RESULTS: Fourteen eyes from fourteen patients (four females and ten males), with a mean age of 56.36 ± 17.74 years and severe zonular loss, were enrolled in the study. All patients were followed up for a mean of 22.5 ± 15.4 months (range 4-49 months). The mean visual acuity improved significantly after surgery (p <
0.002), and the IOLs were well-centered. Postoperative transient intraocular hypertension was observed in one patient. CONCLUSION: This modified technique simplifies the surgical procedures for treating severe lens subluxation and reduces postoperative complications.