Purpose: To compare surgical outcomes of sutureless flanged intraocular lens (IOL) fixation and conventional sutured scleral fixation (SF) for secondary IOL implantation in patients with IOL dislocation. Methods: This is a prospective, comparative cohort study on 103 consecutive patients (103 eyes) with IOL dislocation who underwent vitrectomy with IOL removal and sutured SF (53 eyes) or flanged IOL fixation (50 eyes). Operating time, best-corrected visual acuity (BCVA), refractive difference, IOL tilt and decentration using swept-source anterior segment OCT, and postoperative complications were measured for 12 months. Results: Operating time was significantly shorter for the flanged IOL fixation than for sutured SF (19.4 ± 4.6 vs. 48.9 ± 5.2 min, p < 0.001). BCVA in both groups improved at 1, 3, 6, and 12 months postoperatively (p < 0.05). BCVA in the 2 groups was similar during the 12 months of observation. The refractive difference, IOL tilt, IOL decentration, and incidence of postoperative complications were also not different in the 2 groups. Conclusion: Sutured SF and flanged IOL fixation had similar visual outcomes and IOL stability in patients with IOL dislocation. However, the operating time for flanged IOL fixation was less than half that of the sutured SF. This technique is an efficient alternative for treating IOL dislocation.