Nanophthalmic eyes are very small with a short axial length of less than 20 mm. This makes the cataract surgery far more challenging due to the limited working space. The anterior chamber is typically shallow and the cataractous crystalline lens seems very large in relation to the anterior segment dimensions. Experienced cataract surgeons know that the most challenging cataract cases are often the nanophthalmic eyes. These tiny eyes have a very short axial length of less than 20 mm along with a shallow anterior chamber, less pupil dilation and a smaller anterior segment. Cataract surgery in these eyes can produce some of the most amazing outcomes because there is no better way to surgically address a high degree of hyperopia.