Phakic intraocular lenses have been increasingly popular with refractive surgeons because of the good refractive results achieved and because there are few serious complications. The purpose of this review is to compare the different types of phakic intraocular lenses, regarding implant selection, surgical technique, refractive outcome, and anatomical evaluation. New uses of phakic intraocular lenses are also presented. Although phakic intraocular lenses have gone a long way, the quest for the ideal lens remains a challenge.