ABSTRACT PURPOSE: To assess the efficacy, stability, and safety of Permalens hydrogel intracorneal lenses for the correction of spherical ametropia 6 years after implantation. METHODS: Implantation of intracorneal hydrogel lenses was performed by the same surgeon (JIBM) in five aphakic and five high myopic eyes. The lens closest to corneal vertex refraction was used. Refractive outcomes, keratometry, keratography, endothelial cell count, and corneal topography were studied. RESULTS: Corneal tolerance to the hydrogel implants was maintained throughout for ß years with no alteration in endothelial cell count. All myopic eyes showed regression of achieved correction. The aphakic eyes showed no statistically significant difference between the results at 1 month and those obtained at 1 and 6 years. CONCLUSIONS: Hyrdogei intracorneal lenses are well tolerated and the refractive results are stable in aphakic patients. They may be considered when intraocular lenses cannot be placed in aphakic patients, but are not now in clinical use. [J Refract Surg 1997;13:342-348]