Abstract Introduction: Cataract remains the leading cause of blindness worldwide and manual small incision cataract surgery (MSICS) is the most widely adopted technique in developing countries, where phacoemulsification is not financially viable. Aims and Objectives Primary Objectives: To evaluate safety and efficacy of AC Maintainer in manual small incision cataract surgery, with reference to visual outcome. Other Objectives: To study intraoperative complications, postoperative complications and outcomes. Material and Method: Study Design: Quasi Experimental study Study Period: The study was conducted over a period of 18 months Place of study: The study was conducted at Department of Ophthalmology at Tertiary Care Center. Sample Size: Total sample size were 133 and randomly collection Sampling Method: Complete Enumeration method Result: Sample size is determined by Complete Enumeration method Minimum sample size were 133 and compared to preoperative values, Group I is VISCO group with N=30 and Group II is AC Maintainer also N=30. Discussion: The current study, investigating a new type of anterior chamber maintainer (ACM) and to its reveal a higher incidence of intraoperative and early postoperative complications with its use compared to ocular viscosurgical devices (OVD).