This review is an update of the 1993 review by Charles and Sullivan (Curr Opin Ophthalmol 1993, 4;1:102–106). An effort was made to focus on common and controversial issues. Diabetes is the most common cause of new blindness in the United States. Publications reviewed in this article suggest that two thirds of the diabetic retinopathy patients have visual improvement after cataract extraction. It further suggests that capsulotomy does not have an adverse effect if a posterior chamber lens is present. An efficacious and novel method of repairing retinal detachment with dislocated lenses is reported. This method uses liquid perfluorocarbon which is not yet approved by the Food and Drug Administration. A small series of retinal detachment associated with phakic lens implantation is reported. This article emphasizes the high likelihood of retinal detachment after refractive intraocular surgery in the highly myoptic patient.