Introduction: Findings from specular microscope studies have demonstrated increased endothelial cell loss associated with the use of air for lens implantation. The objective of this study was to evaluate the surgical outcome after cataract surgery with lens implantation using air or viscoelastic to maintain the anterior chamberDesign: Retrospective record analysisSubjects: Record cards of patients operated for cataract at Sakubva Eye Unit, Mutare, Zimbabwe in the period January – December 2002 Main outcome measures: Operative complications, post operative keratitis, presenting visual acuity at discharge, two and six weeks postoperatively.Results: Record cards of 315 patients were analysed, 207 (65.7%) had lens implantation under air, 108 (34.3%) had implantation under viscoelastic. Presenting visual acuity at discharge, two and six weeks postoperatively was better or equal to 6/18 in 36.7%, 34.4% and 52% of patients implanted under air compared to 40.7%, 35.6% and 38.3% of those implanted under viscoelastic. Post operative keratitis was observed in 14% of patients implanted under air and 12% of those implanted under viscoelastic. Vitreous loss was experienced by 1.9% and 5.8% of patients implanted under air and viscoelastic respectively.Conclusion: Despite reports of increased endothelial cell loss associated with use of air for lens implantation, this study finds no difference in surgical outcome between patients implanted posterior chamber lens under air or viscoelastic