We describe a complication of posterior chamber phakic intraocular lens (PCP IOL) implantation for high myopia. Both eyes of a 44-year-old patient were treated prophylactically with a neodymium:YAG laser iridotomy before PCP IOL implantation. Bilateral PCP IOL implantation was performed uneventfully, although a peripheral iridotomy was required immediately after implantation in the right eye because of early pupillary block glaucoma. Two months later, the left eye developed pupillary block glaucoma despite apparently patent iridotomies. The PCP IOLs were subsequently removed.