Dr. Fernando Trinidade reviews 2 cases that each required a unique customized IOL. In the first case, Trindade and his sons made and inserted a single-piece, aspheric, +54 D PMMA IOL for a nanophthalmic eye with an intumescent white cataract, restoring the patient's vision to 20/80. In the second case, they made an opaque, black, PMMA implant for a 22-year-old woman had an undesirable cosmetic appearance in her legally blind right eye due to congenital white cataract. The postoperative course was uneventful, and the implant remained well-centered with an excellent cosmetic result.