Abstract Objective To assess the effectiveness and safety of implantation of a negative, silicone, posterior chamber intraocular lens (IOL) in the ciliary sulcus of phakic, highly myopic eyes. Design Noncomparative consecutive interventional series. Participants Eighteen eyes of 10 patients suffering from high-degree myopia (spherical equivalent < −10 diopters) undergoing implantation of a Fyodorov 094M-1 IOL by the same surgeon (P.H.B.) were evaluated. Intervention A standard surgical technique was used in all patients under peribulbar anesthesia. The IOL was implanted in the ciliary sulcus immediately in front of the natural lens under protection of a viscoelastic substance (Healon) through a 3.5-mm temporal or nasal clear-corneal tunnel. No sutures were necessary in any case. A peripheral iridectomy was performed intraoperatively in 14 eyes, whereas 4 additional eyes received a yttrium-aluminum-garnet peripheral iridectomy after surgery. At the end of surgery, gentamicin and dexamethasone were given both topically and subconjunctivally. Main outcome measures Visual acuity and refraction were measured before surgery, as well as 1 day, 3 months, 6 months, and 2 years after surgery. Postoperative complications were recorded. Results Best-corrected visual acuity remained unchanged (1 eye) or improved (6 eyes by 1, 5 eyes by 2, and 2 eyes by 3 Snellen lines, respectively) in 14 of 17 eyes, whereas 3 eyes experienced a decrease in best-corrected visual acuity by 1 Snellen line. Postoperative refraction approached the desired slight undercorrection at all times of examination. Cataract formation of the anterior subcapsular (8 eyes) or nuclear (only 1 eye) type was observed in overall 9 (52.9%) of 17 eyes. When considering only the patients with a follow-up of 2 years, the incidence of cataract formation was 81.9% (9 of 11 eyes). Conclusions The high incidence of cataract formation should discourage the implantation of the type of IOL used in this study in phakic eyes to correct high-degree myopia.