We retrospectively investigated visual outcome after cataract surgery with implantation of zero or negative-power intraocular lenses (IOL) in 110 eyes with extremely high axial myopia. Extremely high axial myopes can benefit from cataract surgery and implantation of zero or negative-power IOLs with few complications. Factors associated with visual outcome included preoperative best-corrected visual acuity, gender, and age. Method of surgery did not influence the visual outcome.