We present a patient with marginal corneal degeneration and corneal astigmatism of more than 10.0 diopters (D). A toric phakic intraocular lens (IOL) of 7.0 D cylindrical power was implanted in both eyes to correct the high astigmatism. An uncorrected visual acuity of 20/40 was achieved in both eyes, and the best corrected visual acuity improved by 4 Snellen lines to 20/20 in both eyes. Refraction and visual acuity remained stable at 1.5 years postoperatively. Implantation of a toric phakic IOL can be an option to correct high corneal astigmatism even when the full corneal astigmatism cannot be treated.