[Comparative study of extracapsular and intracapsular cataract extraction in Kinshasa (zaire)]

In the developed countries, the great majority of operations for cataract are performed using the extracapsular cataract extraction (ECCE) and phacoemulsification generally combined with the implantation of an intraocular lens in the posterior chamber of the eye. However, in most developing countries, like Zaïre, the more widespread method is still intracapsular cataract extraction (ICCE). In a retrospective study, the results of the 33 first consecutive ECCE with or without IOL performed during six months (from January 1990 through June 1990) were reviewed. These results of ECCE were compared to those of patients who underwent ICCE (52 eyes) during the same period. The follow-up ranged from one month to 32 months with a mean of 7 months for the ECCE group and from one month to 24 months with a mean of 5 months for the ICCE group. The number of eyes that had peroperative complications was one (3%) for the ECCE and 14 (27%) for the ICCE. The number of eyes that had immediate postoperative complications was 12 (36%) for the ECCE and 20 (38%) for the ICCE. And the number of eyes that had later postoperative complications was 4 (9%) and 11 (22%) for respectively the ECCE and ICCE. The most important peroperative complication for the ECCE group was vitreous loss in 6% of the cases compared to 16% for the ICCE group. The most important immediate postoperative complication was striate keratitis (24%) in the ECCE group and striate keratitis (15%), iritis (12%), pupillary block (6%) in the ECCE group. The most important late complications were posterior capsule opacification (6%) for the ECCE and glaucoma (6%) for the ICCE. Of 33 eyes which underwent ECCE, 73% achieved a visual acuity of 0.5 or better. Of 52 eyes which underwent ICCE, 56% achieved a visual acuity of 0.5 or better. In this study, rates of complications were higher in ICCE and visual outcome was better in ECCE. This study shows that the ECCE with IOL implantation would be preferable than the ICCE in our country.