We present our most recent technique of endocapsular phacoemulsification and aspiration (ECPEA) and report the results achieved using it in 50 consecutive eyes of 47 patients. Using a bent 0.9-mm Fragmatome tip, we removed relatively hard cataracts through 1.5-mm anterior capsular openings. With an average follow-up period of 12 months, the success rate was 72%. Causes of failure were anterior capsular openings enlarged more than 2.6 mm in nine eyes, and posterior capsular rupture in five eyes. After the incisions were extended to 6 mm, 11-mm posterior chamber lenses were inserted into the capsular bags. In the successful 36 eyes, postoperative visual acuity of better than 20/20 was achieved in 20 eyes (56%), and better than 20/40 vision in 31 (86%). Average corneal endothelial cell loss was 3.7%. Ample anterior capsular transparency was retained in 26 eyes (72%).
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