The advantages of small-incision surgery, either phacoemulsification or MSICS, are: more controlled operating conditions, avoidance of suturing, rapid wound healing with lesser degrees of corneal distortion, and reduced postoperative intraocular inflammation—all contributing to more rapid visual rehabilitation. The main intraoperative complication of extracapsular surgery is posterior capsular tear, for which the main predisposing factors include previous trauma, dense cataract, unstable lens, and small pupil, possibly leading to displacement of nuclear material into the vitreous (“dropped nucleus”) that generally necessitates complex vitreoretinal surgery. Postoperatively there may be secondary opacification of the posterior capsule that requires discission using the neodymium:YAG laser (see Posterior Capsule Opacification later in the chapter).