Extracapsular Cataract Extraction (ECCE): Procedure Overview

ECCE removes the anterior lens capsule and cataractous nucleus/cortex, leaving the posterior capsule intact to support an intraocular lens (IOL).

Steps

1. Large corneal or scleral incision (10–12 mm).
2. Anterior capsulotomy.
3. Expression or phacoemulsification of nucleus; aspiration of cortex.
4. IOL implantation in the capsular bag.
5. Sutured wound closure.

Indications Today

• Very dense cataracts unsuitable for phaco.
• Zonular weakness with capsular support.
• Resource‑limited settings without phaco machine.

Modern phacoemulsification (small incision, no sutures) has largely replaced ECCE for routine cases.