To study the clinical effects of 1.8mm coaxial microincision phacoemulsification and negative power intraocular lens implantation for the patients with cataract and extreme myopia. METHODS: A retrospective study was carried out on 98 eyes of 71 cases with a history of cataract and extreme myopia. The patients received phacoemulsification and a negative power intraocular lens implantation. Preoperative axial length, visual acuity, best-corrected visual acuity(BCVA) were recorded. Intraoperative and postoperative complications were observed. The follow-up time was from 3 to 6 months. Postoperative visual acuity, BCVA were recorded. RESULTS: The mean preoperative axial length was 29.33±1.95mm. The preoperative visual acuity of the patients were all bellow 0.05. The postoperative uncorrected visual acuity (UCVA )achieved 0.3 in 60 eyes (61%) and the BCVA achieved 0.5 in 48 eyes (49％) after the operation. Only 1 eye had posterior capsule rupture during the operation. 20 eyes had binocular disturbances. 6 eyes developed posterior capsule opacification and 5 eyes were performed neodymium: YAG laser posterior capsulotomy. There were no retinal detachment or choroidal detachment during the follow-up. CONCLUSION: The 1.8mm coaxial microincision phacoemulsification and negative power intraocular lens implantation is safe and effective for cataract and extreme myopia.