Six eyes of 4 patients with anterior megalophthalmos, 2 men and 2 women ranging in age from 32 to 47 years, had extracapsular cataract extraction or phacoemulsification and standard posterior chamber intraocular lens implantation. All had a family history of anterior megalophthalmos. Follow-up was from 6 to 30 months. All patients had a preoperative visual acuity of worse than 20/60, which improved to 20/20 in 5 eyes. Zonular dehiscence was observed during surgery in 3 cases, leading to vitreous loss in 1 case that developed a retinal detachment after 3 months.