Objective To evaluate the efficacy, predictability, stability, and safety of implantation with a modified capsular tension ring (M-CTR) and intraocular lens (IOL) in abnormal zonular eyes with cataracts.Methods A prospective case-control study was adopted to analyze 12 eyes of 12 patients who underwent IOL implantation and M-CTR insertion with a scleral suture fixation for the treatment of cataracts with zonular weakness.The study was conducted from April 2009 to April 2010.Twelve eyes of 12 patients who had undergone standard phacoemulsification and IOL implantation during the same period acted as the control group. Patients were examined preoperatively and were followed up at 1,3 and 6 months postoperation.The examinations included uncorrected visual acuity,best corrected visual acuity (BCVA),the tilt and decentration of the IOL,ocular aberrations, etc.An independent samples t test was used for statistical analysis.Results Successful implantation was achieved in all eyes.Postoperatively, BCVA improved in all eyes.No dislocation of the M-CTR or IOL was detected at 6 months postoperatively.There was no statistically significant difference in the decentration of the IOL or the spherical aberrations between the two groups.The tilt of the IOL was 3.97°±1.40°(1.81°～5.68°) in the experimental group and was 1.57° ±0.92°(0.70°～2.73°) in the control group.There was a statistically significant difference between the two groups (t=3.058,P=0.010).The coma in the experimental group was (0.32 ±0.11)μm and was (0.17±0.13)μm in the control group.There was a statistically significant difference,between the two groups (t=2.335,P=0.047).Conclusion Phacoemulsification with a M-CTR and IOL implantation provides efficacy and predictability,and is safe and reliable.