Purpose: To evaluate the complexities of small incision cataract surgery in senile cataract with pseudoexfoliation syndrome and its management

Methods: This Observational clinical trial was conducted on the patients with cataract and PXF presenting themselves directly to ophthalmology OPD of Rajindra hospital Patiala from Feb 2017 to Nov 2017. All patients will be given systemic antibiotics on the preoperative day. On the day of surgery pupil of the operating eye is dilated adequately using instillation of 0.8% tropicamide and 5% phenylephrine eye drops (phenylephrine eye drops avoided in hypertensives) every 10 minutes for 3 times, one hour before surgery. Under aseptic precautions the Manual Small Incision Cataract Surgery will be carried out under Local anesthesia. The patients were reviewed 1st week, 4th week and 6th week post operatively recording unaided vision and finally unaided vision and best corrected visual acuity on 45th day.

Results: There were stastically significant Difficulty during anterior capsulotomy, nucleus delivery, Corneal endothelial touch was noted in patients, Descemet’s membrane detachment was not noted in any patients, Zonular dialysis , Posterior capsular rent, Vitreous loss , Residual lens material , Iridodialysis was noted in patients. For management Viscomydriasis/manual iris stretching , sphincterotomy, Use of iris hooks, CTR implantation,  anterior vitrectomy was done patients.

Conclusion: Patients with cataract and PXF posted for manual small incision cataract surgery have to be carefully assessed preoperatively for insufficient mydriasis, zonular weakness, subluxation or dislocation of cataractous lens, because these pre– operative factors have bearing on the intraoperative complications and visual outcome.