Materials and Methods: This retrospective study was carried out from medical records of cataract patients operated in the 1st Ophthalmology Clinic of Ataturk Training and Research Hospital Ankara Turkey between January 1st 2005 and April 1st 2006. Patients having mature cataract with cataract hardness of four plus were included. Cases with any risk factors for development of postoperative corneal edema in their preoperative examination were excluded. A total of 123 patients 40 years or older were enrolled in this study. Cataract operation was performed by ECCE in 39 cases and by phacoemulsification in 84 cases. Corneal edema was assessed using Efron corneal edema grading system at first and seventh postoperative day.

Results: On the first postoperative day, in phacoemulsification group, 19 cases (22.6%) had grade III and 4 cases (4.8%) had grade IV corneal edema whereas in ECCE group, 3 cases (7.7%) had grade III and one case (2.6%) had grade IV corneal edema. Frequency of severe corneal edema was found to be significantly higher in phacoemulsification group (p=0.019). In postoperative seventh day, 4 cases (22.6%) had grade III and 1 case (4.8%) had grade IV corneal edema in phacoemulsification group however in ECCE group, there were no cases with grade III or grade IV corneal edema. The difference between groups was significant (p=0.019).

Conclusions: Severe early postoperative corneal edema rates were higher after phacoemulsification than ECCE. The increased risk of severe postoperative corneal edema with phacoemulsification in patients with hard cataracts suggests that phacoemulsification may not be the optimal procedure in these cases, and that ECCE might be preferred. Keywords : Phacoemulsification, corneal edema, ECCE