AIM:To compare the effects of Acrysof Natural intraocular lens(IOL)implantation and silicone IOL implantation,for cataract with exfoliation syndrome(EFS).METHODS:Totally 65 EFS cataract patients(70 eyes) who had no glaucoma history were selected,and phacoemulsification was performed in the patients.60 cases 63 eyes had no complications during operation.30 cases 33 eyes were implanted Acrysof Natural IOL,the another,30 cases 30 eyes,were implanted silicone IOL with implantation apparatus.The complications,visual acuity,intraocular pressure(IOP),anterior chamber,the stability of IOL were statistically analyzed at 1 day,1 week,3 months,1 year after operation.RESULTS:Acrysof Natural with slow progresion in implantation and good controllablility could still be properly implanted even if the EFS patients’ pupils were not easily dilated,and without any other complication.In contrast,silicone spread quickly rotated during operation in 7 eyes,Posterior capsule rupture happened in 5 eyes(16.6%) during implantation because the observation and control became more difficult due to pupil dwindled in some defected zonule cases(7 eyes).One silicone IOL sprung into vitreous body.The implantion through ciliary sulcus after taking it out from vitreous body was chose.The postoperative visual acuity of posterior capsule rupture was not calculated in the statistics.CONCLUSION:IOL implantation surgery for cataract patients with EFS has high risks because it is not so easy to dilate their pupils and their ciliary zonule is brittle.Some complications occur in surgery,such as posterior capsule rupture,ciliary zonule break,vitreous body prolapsus and IOL dislocation.The softer Acrysof Natural IOL with slow progression,good controll ability in operation and few complication is applied widely.It also has some other advantages,such as relatively thin optical parts,better stability,relatively deeper anterior chamber,more compatible with organisms,slighter postoperative reaction.