Fifty-three cataract extractions in eyes with pathological myopia effected visual improvement in 47 eyes (89%). The median visual acuity increased from a preoperative level of 20/300 to 20/40 postoperatively. The incidence in this series of vitreous loss (1.9%) and retinal detachment (1.9%), are within the expected range of such complications. Four cases developed aphakic glaucoma which has necessitated continued therapy. All four had both enzyme zonulolysis and topical steroids, postoperatively. Other problems unique to surgery in these eyes are the missed diagnosis of nuclear cataract, possible dislocation of the lens, perforation of the sclera during retrobulbar injection, and rupture of the globe with vigorous digital massage.