Objective: To explore the corrective effect of posterior chamber intraocular lens implantation with phakic eyes in the treatment of high myopia and astigmatism. Methods: From May 2023, the hospital began to collect the case data of diagnosis and treatment of high myopia and astigmatism. By May 2024, 310 cases were included, all of which were treated with posterior chamber intraocular lens implantation. The visual acuity, astigmatism and axial position of the intraocular lens were observed before and after treatment. Results: At different time points after the operation, the patient’s vision was significantly improved compared with that before the operation (P < 0.05), and the vision level was equal to or greater than the best-corrected vision before the operation. At different time points after the operation, the average rotation of the intraocular lens was less than 5 degrees. Astigmatism was significantly lower than that before the operation (P < 0.05). After the operation, the intraocular pressure increased in 11 cases, accounting for 3.55%, with no adverse complications such as lens turbidity, glare and obvious halo occurring. Conclusion: The posterior chamber intraocular lens implantation with phakic eyes has an ideal correction effect in the treatment of high myopia and astigmatism, which can effectively improve the vision level of patients and reduce the degree of astigmatism, and has high effectiveness and safety.