Cataract surgery challenging in highly myopic eyes

Cataract surgery in the highly myopic patient, typically defined by an axial length greater than 26 mm, represents one of the most demanding scenarios in refractive cataract surgery.
While these patients often have the most to gain in terms of visual quality of life, they also carry a significantly higher risk profile for intraoperative complications and postoperative refractive surprises. As surgeons, our approach must be multifaceted, beginning with meticulous biometric analysis and extending to a lifetime of vitreoretinal vigilance.
The primary hurdle in high myopia is the refractive