Purpose: To evaluate the visual outcome in patients with hypermature cataracts after small incision cataract surgery. Materials and Methods: This study was conducted in the Department of Ophthalmology, Navodaya Medical Hospital, Raichur, from december 2017 to may 2018. In this study, evaluation of hundered patients with senile hypermature cataract after pre-operative assessment and investigations underwent small incision cataract surgery. Their surgical and post-operative complications were recorded. Their visual outcome was studied at post-operative day 1, 1 week and 6th week. Best corrected visual acuity was obtained at 6 weeks. Results: Total of hundered patients with 42 male and 58 female had small incision cataract surgery. 8 of the eyes had surgery complicated by posterior capsule rupture, vitreous loss, zonular dialysis. On first post-operative day most common complication noted was striate keratitis (39%). Best corrected visual acuity at 6 weeks was 6/18 in 58 (58%) patients. Conclusion: The intraoperative and post-operative complications rate is higher in hypermature cataracts. These complications can be reduced by early removal of cataract before it reaches the stage of hypermaturity. Small incision cataract surgery of hypermature cataract has good results after thorough pre-operative assessment and if performed with expertise.

Keywords: Capsulorrhexis; Hypermature cataract; Manual small incision cataract surgery