The popularity of phakic IOLs in both cataract and refractive surgery has soared in recent years with lens manufacturers all joining the race to develop better lenses with improved outcomes and fewer complications. Although phakic IOLs are considered the ideal tools for the correction of high ametropias, because of their excellent accuracy and predictability, stability of refraction from day one and independence of tissue healing, they have, unfortunately, been marred by reports of certain complications throughout their development history. These complications include corneal decompensation, chronic inflammation, iris atrophy (pupil distortion), cataract and glaucoma. Here, Ant?nio Marinho, MD, PhD discusses the influence of phakic IOLs on cataract and glaucoma development.