Cataract surgery has evolved dramatically over the last two decades, largely as a result of technological advances. As a result, visual outcomes and patient convalescence have improved significantly.Cataract extraction with phacoemulsification is a highly refined surgery. When performed well, this elegant procedure provides the surgeon and patient with unparalleled satisfaction.One of the biggest challenges facing the surgeon when dealing with a patient with a cataract and high myopia is making the correct diagnosis in the first place. Often these cataracts appear less dense than the symptoms would suggest. Accurate diagnosis can spare the patient unnecessary time wasted between presentation and treatment, and it can avoid many unnecessary tests.Surgery is generally proceeded by a noninjection method of anesthesia, such as irrigating the anterior chamber with 0.5 cc of 1% unpreserved lidocaine. The anterior chamber pressure should be maintained with phacoemulsification, both to avoid trauma to the vitreous and to maintain a fixed-pupil diameter. The distance the cataract sits from the cornea is a challenge, partially compensated by the relative exophthalmos and excellent exposure.Patients with eyes with excellent vision potential tend to prefer a postoperative refraction between emmetropia and -3.00 D of myopia. If the potential is worse than 20/200, many patients prefer -5.00 D of myopia for the reading magnification effect.All old intraocular lens (IOL) calculation programs are hopelessly inaccurate when dealing with long eyes. The theoretical formulas which compensate for the length of the eye, including the relative increased length of the anterior segment are better. The theoretical formulas most commonly used are the SRK-T, Holladay, and the Hoffer Q.Significant complications, such as retinal detachment, are decreased to 0.9 % when phacoemulsification technique is used. Posterior capsule opacification occurs quickly in many patients possibly because of their young ages. The inevitability of a capsulotomy in many eyes can be anticipated and potential complications controlled by implanting an intraocular lens to maintain ocular integrity and to establish a physical barrier to prevent vitreous prolapse after the capsulotomy.If the various unique features of cataract surgery in eyes with high myopia are kept in mind, cataract surgery can proceed as smoothly as in a more routine case. Postoperative care and complications can also be very close to the normal for emmetropic eyes.Conclusion : Phacoemulsification and the posterior chamber IOL implantation offers the advantages of rapid wound healing, short convalescence and early stabilization of refractive error with less astigmatism and decreased incidence of complications as well as importance of phacoemulsification as a refractive surgery in correction of high myopia.