ABSTRACT We report a case of a highly myopic patient with a single functional eye, previously vitrectomized, and implanted with an anterior chamber phakic intraocular lens (Artisan®), who underwent phacoemulsification with phakic lens explantation and posterior chamber intraocular lens implantation. The case illustrates the surgical challenges and highlights the importance of individualized planning in patients with multiple prior interventions and at high risk of complications.