This study analyzes the temporal relationship between intraocular lens surgery and nonarteritic anterior ischemic optic neuropathy (NAION). Retrospective cohort study. Eighteen cases of NAION in 17 subjects occurring within 1 year after lens-related surgery were identified with a retrospective review of patients diagnosed with NAION. The temporal relationship between NAION onset and surgery was evaluated by using an exact chi-square test of goodness of fit to compare the observed with a uniform distribution, which would be expected if intraocular surgery were not causal. All 18 cases occurred within 6 months of surgery (mean interval, 35 days; range, 1-130 days), which is significantly different from a uniform distribution (P <.001). Our data indicate that intraocular lens surgery is associated with the occurrence of NAION.