OBJECTIVE To evaluate the effectiveness of the surgical correction of high myopia 5 years after anterior chamber intraocular lens (IOL) implantation and to analyze the lens position and related complications. METHODS Federal University of São Paulo-Escola Paulista de Medicina, São Paulo, Brazil. METHODS This prospective study comprised 26 eyes that were implanted with an anterior chamber IOL (model ZB5M) and had a minimum follow-up of 5 years. Before and after surgery, manifest and cycloplegic refractions were done; slitlamp examination was performed; anterior chamber depth was measured; and keratometry, ophthalmoscopy, and central corneal endothelial cell count were performed. At the last follow-up, computerized biomicroscopy of the anterior segment was also done. RESULTS The spherical equivalent decreased from -16.5 diopters (D) +/- 4.1 (SD) preoperatively to -0.9 +/- 0.9 D postoperatively. At the last examination, 57.7% of eyes had a spherical equivalent refraction within +/-1.0 D of emmetropia. Of eyes with a preoperative best spectacle-corrected visual acuity of 20/40 or better, 73.3% had an uncorrected visual acuity of 20/40 or better postoperatively. The mean tilt caused by the IOL was 4.4 +/- 2.7 degrees (range 0.5 to 12.2 degrees) and the mean IOL decentration, 0.3 +/- 0.2 mm (range 0.02 to 0.8 mm). The mean decrease in the endothelial cell count was 1.5%, with a mean cell density of 2808 +/- 305 cells/mm2 preoperatively and 2765 +/- 242 cells/mm2 postoperatively. Pupillary ovalization was observed in 12 eyes (46.1%). CONCLUSIONS The anterior chamber IOL safely and effectively corrected high myopia.