Rajendrababu S, et al. - A randomized controlled trial is done to prospectively assess visual outcomes and complications amid and after cataract surgery with or without prophylactic sclerostomy in nanophthalmic eyes with visually significant cataract. Based on these outcomes, cataract surgery in eyes with nanophthalmos is related to a high risk for vision threatening complications. Performing a simultaneous prophylactic sclerostomy with cataract surgery decreases complication rates, especially uveal effusions. At an earlier stage, cataract surgery phacoemulsification may be more beneficial than undergoing manual small incision cataract surgery (SICS).