Background: Cataract is the major cause of blindness in the developing world. This study aimed at evaluation of tear film stability and tear secretion after phacoemulsification compared with MSICS. Materials and methods: This was a prospective, comparative randomized study that included 100 patients diagnosed with senile cataract. Patients fulfilling the inclusion and exclusion criteria were enrolled and randomized into 2 groups of 50 patients each: Group A who underwent manual small incision cataract surgery (SICS) and Group B who underwent cataract surgery with phacoemulsification technique. Post-operatively follow up was done at 1 week, 1 month and 3 months respectively in both the groups. The patients were subjected to same TBUT, Schirmer’s and OSDI scoring at each visit. Results: Comparison between two groups showed non significant tear film and ocular surface indices over period of three months. Both groups showed initial reduction in mean Schirmer’s and TBUT at immediate postoperative period ( 1 week) followed by gradual improvement to near baseline at 1 and 3 months postoperative follow up period but still significantly lower than the preoperative values. Both groups showed initial increased in mean OSDI score at 1 week followed by gradual decreased in mean OSDI score at 1 and 3 months postoperative follow up period.