Zheng T, et al. - This paper explored the long-term visual outcomes, complications and prognostic factors for cataract surgery in extreme microphthalmos. Visual improvement was yielded with cataract surgery, in extreme microphthalmos (simple microphthalmos and RAM), with higher risks of complications in comparison with routine cataract surgeries. An additional benefit could be gained from cataract surgery by the extreme microphthalmos with preoperative characteristics of relatively longer AL, deeper ACD and better best-corrected visual acuity (BCVA).