Total cataract extraction through a 3-mm incision: a report of 650 cases

We treated 650 consecutive cases of phacoemulsification with total capsulectomy. More than 91% of cases had best corrected visual acuities of 20/40 or better. In those with vision of 20/100 or less (3.5%) no cause for decreased acuity could be related to the surgery; 94% of cases had less than 1.5 diopters of residual astigmatism. Vitreous loss, occurring in 2.9% of cases, could be related to initial inexperience and errors in technique rather than patient age. Postoperative complications included transient striate keratitis (2.3%), persistent corneal edema (one case), cystoid macular edema (2.8%), and aphakic retinal detachments (2.6%). There were no hyphemas, flat or shallow anterior chambers, or filtering blebs postoperatively. We believe that this technique of total cataract extraction through a 3-mm incision yields the same results as an intracapsular extraction, but with less complications, and all the benefits of a small limbal incision.