Anterior megalophthalmos is characterized by megalocornea associated with a very broad anterior chamber and ciliary ring elongation. It is also known as X-linked megalocornea. It is accompanied by the early development of cataracts, zonular anomalies, and rarely vitreoretinal disorders. Cataract surgery involves the risk of subluxation of the cataract because zonular weakness. In addition, in most cases, standard IOL decentration is a danger due to the enlargement of the sulcus and capsular bag. Cataract surgery is challenging because of these unique circumstances. Several approaches have been performed to date. Implantation of a retropupillary iris-claw aphakic intraocular lens might be a good option, since it is easier than suturing the IOL and could have better and more stable anatomic and visual outcomes compared with the other techniques
