Abstract: Highly myopic cataract, as a complex cataract type associated with a high risk of blindness, significantly increases the incidence of postoperative complications, thereby posing a serious threat to the visual health of highly myopic individuals. The common postoperative complications associated with high myopia-related cataracts, include early intraocular pressure elevation, capsular contraction syndrome, posterior capsular opacification, and intraocular lens dislocation. Previous studies have shown that the pathological changes in highly myopic eyes, such as anatomical abnormalities caused by axial elongation, intraocular microinflammatory environments, and oxidative-antioxidative imbalances, contribute to structural and dynamic anomalies in aqueous humor outflow, epithelial-mesenchymal transition of lens epithelial cells, and loosening of the zonular fibers. These factors collectively increase the risk of postoperative complications. Clinically, measures such as meticulous polishing of the capsule during surgery, cautious use of capsular tension rings, and close postoperative monitoring with early intervention can help mitigate these complications to some extent.  (Int Rev Ophthalmol, 2025, 49:  13-18)

Key words: cataract, high myopia, postoperative complications