AIM:To investigate the clinical effect of silicone oil removal combined with manual small incision extracapsular cataract extraction and intraocular lens (IOL) implantation. METHODS:Fifty-six cases (56 eyes) of complicated cataract induced by silicone oil-filled eye underwent silicone oil removal combined with manual small incision extracapsular cataract extraction and intraocular lens implantation. Postoperative follow-up ranged from 3 to 12 months with medium 7.26±1.38 months. Data were collected on corrected visual acuity, intraocular pressure (IOP), reaction of anterior chamber, location of IOL, opacity of posterior capsular, vitreous hemorrhage and reattachment of retina. RESULTS:Postoperative visual acuities of 53 eyes (95%) increased, ≥0.05 in 47 eyes（84%）, ≥0.3 in 27 eyes（48%）, there was significant difference between preoperative and postoperative vision (P＜0.05). Four eyes (7%) had temporary ocular hypertension and recovered by local drugs. Posterior capsulectomy was performed with the Neodymiun: YAG laser in 15 eyes (27%), retinal detachment happened in 2 eyes (4%). None of the cases had complications, such as bullous keratopathy,silicone oil residues, IOL displacement and vitreous hemorrhage. CONCLUSION:Silicone oil removal combined with manual small incision extracapsular cataract extraction and intraocular lens (IOL) implantation is a safe and effective method for complicated cataract induced by silicone oil-filled eye, it can improve vision, shorten period of surgery and reduce times of surgery.