In this video presentation from the 2013 Refractive Subspecialty Day, Antonio Marinho discusses shows where we have been, where we are now, and where are we headed. Phakic IOLs have been part of modern ophthalmology practice since the pioneering work of Baikoff, Worst, and Fyodorov in the late 1980s. Different models have been suggested and tried since, but have been discarded due to unacceptable complications. These complications are typically long-term and due to the interference of the phakic IOL with the surrounding structures of the eye. Yet phakic IOLs also provide very accurate refractive correction, stability from day 1, a wide range of ametropia correction, and superior vision quality.