AIM: To compare the visual quality of cataract patients with high myopia after regional refraction or diffraction refraction multi-focal intraocular lens(MIOL)implantation by using objective optical quality analysis system(OQASⅡ).METHODS: Retrospective study. From January 2019 to January 2020, 38 patients with 44 eyes diagnosed as cataract with high myopia that had underwent femtosecond laser-assisted phacoemulsification combined with intraocular lens implantation in our hospital were selected. Regional refraction MIOL group includes 19 cases 22 eyes, and diffraction refraction MIOL group includes 19 cases 22 eyes. After 3mo follow up, OQASⅡ measured objective visual quality and questionnaire surveys were conducted on the subjective visual quality of the patients. Record the patient's subjective near spectacle independence, visual disturbance symptoms, and satisfaction.RESULTS: After 3mo follow-up, the uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA)and uncorrected near visual acuity(UCNVA)had no difference(P>0.05), and the best corrected distance visual acuity(BCDVA), best corrected intermediate visual acuity(BCIVA)and best corrected near visual acuity(BCNVA)had no difference(P>0.05). The objective scattering index(OSI)values of regional refraction MIOL group and diffraction refraction MIOL group were 1.97±1.10 and 2.07±1.02(P=0.755). The MTF cut off of regional refraction MIOL group and diffraction refraction MIOL group were 31.89±14.61 and 33.17±9.83c/deg, respectively(P=0.734). There was no statistically significant difference in OV100%, OV20%, OV9% between the two groups(all P>0.05).CONCLUSION: Cataract patients with high myopia can obtain better distance, middle and diffraction refraction MIOL implantation, and OQASⅡ can objectively reflect the visual quality after cataract surgery.