Mr. Yu is 59 years old and has been suffering from high myopia for more than 30 years, with super high myopia in both eyes, 3000 degrees in his right eye and more than 2000 degrees in his left eye. In recent years, with the increasing degree of cataract, he could not see clearly even in front of his nose and was on the verge of losing his sight. Mr. Yu went to many hospitals in Shanghai to seek treatment, but the examination results were disappointing. Because of the high degree of myopia, the cataract had developed nearly black and the operation was very risky, and it was difficult to estimate the effect of the operation; moreover, he was told that the peripheral cornea of the right eye was degenerative and thin, accompanied by large astigmatism, which increased the difficulty of the operation and the uncertainty of the effect. However, Mr. Yu’s strong desire to regain his sight made him unwilling to give up his treatment. Six months ago, he came to our ophthalmology hospital with the intention of giving it a try, and met me by chance at the specialist clinic, and after communication, he felt that he could trust me as a doctor, and after checking my personal information and other patients’ experiences on the Internet, he finally decided to give me his nearly ruined eye. After careful design and preparation, I performed a cataract extraction combined with IOL implantation in his right eye, choosing an IOL that minimized his myopia. Although the corneal astigmatism could not be removed, the cataract was removed and the myopia was reduced to 250 degrees, eliminating the need for glasses and achieving a naked eye vision of 0.4. The surgery was surprisingly successful. Two weeks later, Mr. Yu had the same surgery on his other ultra-high myopic eye with cataract, and it was also successful, with a corrected visual acuity of 0.8! Ms. Wen, who is nearly half a hundred years old, can’t get glasses because one eye is nearly 1,000 degrees nearsighted and the difference between the two eyes is more than 600 degrees, so this eye has become virtually useless. Not long ago, she came to me with the same mentality of “treating a dead horse as a living horse” and underwent clear lens removal combined with IOL implantation, which reserved 350 degrees of myopia. Super high myopia is a state of myopia with a refractive error greater than -9.0DS. Patients often have cataracts, pathological myopia, prolongation of the eye axis and stromal changes, such as temporal arcuate spots, thinning of the pigment epithelium, leopard’s eye fundus, Fuch’s spots, retinal choroidal atrophy and other fundus changes. With the development of medical technology, for the correction of super high myopia, there are already options such as excimer or femtosecond laser keratomileusis, IOL implantation for crystalline eyes and ultrasonic emulsification lens aspiration combined with IOL implantation. For patients over the age of fifty or even forty, the adjustment power of the eyes is gradually going downhill and cataracts are becoming more and more visible. In recent years, ultrasound emulsification surgery has become increasingly mature, and the surgical incision has even been reduced to 1.8mm, further reducing surgical complications and greatly increasing surgical expectations. Moreover, in order to meet the different needs of various people for visual quality, various IOLs such as monofocal, multifocal, toric surface for astigmatism correction and aspheric for better night vision have been created, increasing the selectivity and flexibility of this procedure. Compared to laser surgery, which causes irreversible corneal thinning and corneal dilatation due to excessive cutting of corneal tissue, and the potential complications of crystalline eye surgery, such as cataract and glaucoma, the author believes that for patients over 40 years of age with high or ultra-high vision, the safety and predictability of ultrasonic phacoemulsification surgery has its advantages, and its efficacy often brings unexpected surprises to both patients and doctors. This is a good example of two cases in which the long-term results are even more promising. Some patients are reluctant to choose surgery for fear of poor postoperative vision, but this is not necessary. While it is true that patients with high myopia may not be able to see as well as normal after surgery due to a variety of complications in the fundus, this is not always the case. The multiple options of IOLs allow the surgeon to “tailor” the surgery to meet the needs of different people in terms of distance and near vision, and for patients with cataracts, the surgery can kill two birds with one stone, showing extraordinary results. For patients with cataracts, the surgery is a two-pronged approach, with exceptional results. For patients with high myopia with a large difference between the two eyes, the surgery can also be used to achieve a balanced binocular vision and greatly reduce double vision and fatigue.