A 31-year-old male with bilateral microphthalmos and a history of severe refractive amblyopia presented with early nuclear sclerosis. Intraocular lens calculations determined the patient would need about a 46.0 diopter power intraocular lens in both eyes to achieve satisfactory vision postoperatively. When no manufacturer could or was willing to make such a high-power lens, we chose to implant two lenses in each eye. The patient is satisfied with his postoperative vision and overall outcome.