Myopia and cataracts are frequently associated: a cataract may lead to index myopia; high myopia is complicated by the frequent and early development of cataracts. In this case, given the retinal fragility, there are problems in operating techniques and indication. Extra-capsular extraction with in-the-bag implantation is the safest technique. A lens implant of well-calculated strength can best correct a preexistent myopia. The refractive goal varies according to the patient's age and activity. Intra and postoperative complications are rarer than expected with such abnormal eyes. A useful visual acuity can be obtained in 90% of the cases.