Phakic intraocular lenses (pIOLs) are an effective solution for the correction of high ametropia, offering significant visual improvements for patients unsuitable for other refractive procedures. While intraoperative complications are closely linked to the surgeon’s learning curve, postoperative complications are rare but remain a possibility. Advances in pIOL design have significantly reduced the incidence of severe complications, such as the loss of endothelial cell count, which was more common with earlier models. Continuous innovation in this field ensures improved safety and efficacy for patients undergoing this procedure.