Purpose: To compare vision quality following phacoemulsifi-cation cataract extraction and implantation of a Big Bag or Akreos Adapt intraocular lens (IOL) in patients diagnosed with high myopia complicated with cataract. Methods:.This was a randomized prospective control study. The patients with high myopia complicated with cataract , with axial length ≥28 mm,.and corneal astigmatism ≤1D were enrolled and randomly divided into the Big Bag and Akreos Adapt IOL groups. All patients underwent phacoemulsification cataract extraction and lens implantation..At 3 months after surgery,.intraocular high-order aberration was measured by a Tracey-iTrace wavefront aberrometer at a pupil diameter of 5 mm in an absolutely dark room and statistically compared be-tween two groups. The images of the anterior segment of eyes were photographed with a Scheimpflug camera using Penta-cam three-dimensional anterior segment analyzer..The tilt and decentration of the IOL were calculated by Image-pro plus 6.0 imaging analysis software and statistically compared between two groups. Results:.In total,.127 patients (127 eyes),..including 52 males and 75 females, were enrolled in this study. The total high-or-der aberration and coma in the Akreos Adapt group (59 eyes) were significantly higher compared with those in the Big Bag (P0.05). The horizontal and vertical decentration were significantly smaller in the Big Bag lens group than in the Akreos Adapt group (both P0.05). Conclusion:.Both Big Bag and Akreos Adapt IOLs possess relatively good intraocular stability implanted in patients with high myopia. Compared with the Akreos Adapt IOL, the BigBag IOL presents with smaller intraocular high-order aberra-tion. Coma is the major difference between the two groups.