Retinal detachment following intracapsular and extracapsular cataract extraction.

In 1984, our ophthalmology department switched from intracapsular cataract extraction (ICCE) to extracapsular cataract extraction (ECCE). We reviewed the postoperative incidence of retinal detachment (RD) in two consecutive series: (1) 604 eyes operated on by ICCE from 1982 to 1983 and (2) 1726 eyes operated on by ECCE from 1985 to 1986. Follow-up averaged 39 months in both groups. The RD incidence was 1.30% after ICCE and 0.41% after ECCE, a statistically significant difference. In both groups, the risk of RD was high for patients less than 70 years of age at the time of surgery but minimal for patients older than 70 years. The proportion of younger patients was significantly higher in the ICCE group (29.5%) than in the ECCE group (23.2%). When the data were stratified by age and the difference in age composition adjusted for statistically, the difference between the two groups in the incidence of postoperative RD was less pronounced. We conclude that although not significant at the 5% level after adjusting for age distribution, our results suggest a decreased risk of RD with ECCE.