The ICARE anterior chamber phakic intraocular lens (IOL) with angle-supported haptics was designed five years ago by Corneal Laboratories (France) and attained the CE mark for demonstrating good efficacy and stability of refractive outcomes for the correction of high myopia. However, the safety profile of the lens was compromised by a number of anatomical limitations: a high vaulting that placed the optic too close to the endothelium and, because of the overall design of the lens, accurate sizing was difficult. In our clinic, in a series of 44 cases of conventional ICARE implantations, there were three reports of ovalisation and two of endothelial cell density decrease, which necessitated the removal of the lens.