Objective To investigate the clinical effect of posterior chamber phakic intraocular lens implantation in patients with high myopia. Methods A total of 78 patients with high myopia admitted to Laixi Hospital of Traditional Chinese Medicine from February 2023 to February 2024 were randomly divided into reference group and study group, with 39 patients in each group. The reference group was treated with clear crystal extraction+intraocular lens implantation, and the study group was treated with posterior chamber phakic intraocular lens implantation. The intraocular pressure level, uncorrected visual acuity level and adverse reactions were compared between the two groups. Results The intraocular pressure level of the two groups after treatment was slightly lower than that before treatment, but the difference was not statistically significant (P >0.05). The uncorrected visual acuity of the two groups after treatment was higher than that before treatment (P <0.05). There was no statistically significant difference in the intraocular pressure level and uncorrected visual acuity between the two groups after treatment (P >0.05). The incidence of adverse reactions in the study group was 5.13%, which was lower than 20.51% in the reference group (P <0.05). Conclusion The reasonable selection of posterior chamber phakic intraocular lens implantation in patients with high myopia can improve the naked eye vision of patients, and the postoperative safety is high, which is worthy of clinical application.