Comparison of intracapsular and extracapsular cataract surgery. Histopathologic study of eyes obtained postmortem.

We examined 201 consecutive aphakic and pseudophakic eyes postmortem. Of these, 146 eyes had undergone intracapsular cataract extraction (ICCE) and 55 eyes had undergone extracapsular cataract extraction (ECCE), either with the posterior capsule preserved intact (ECCE-CI, 30 eyes) or having had a surgical discission performed (ECCE-D, 25 eyes). Wound-related complications were most numerous in the ICCE group, and this probably reflects the relatively recent development of microsurgical techniques. Posterior vitreous detachment was present in 84% of eyes following ICCE, in 76% of eyes following ECCE-D, and in 40% of eyes following ECCE-CI (P less than 0.001). Peripheral retinal holes were found in 8.2% of ICCE eyes, 8.0% after ECCE-D, and 3.3% of eyes after ECCE-CI. Five (3.4%) of ICCE eyes had associated retinal detachments, while no ECCE eyes had detachments. Macular edema, macular holes, and epiretinal membranes occurred in 2.1%, 1.4%, 12.3% of ICCE eyes; 4.0%, 0.0%, and 8.0% of ECCE-D eyes; and 0.0%, 6.7%, and 6.7% of ECCE-CI eyes, respectively.