EyeWorld:  The lack of training of extracapsular cataract extraction (ECCE) has struck some educators as being a problem- it’s really a good operation, and it really comes in handy when one has a very compromised eye. In fact, it’s probably the better choice than phaco in several scenarios. I did half my cases as ECCE as a resident- I’m really good at it. Residents today sometimes barely do a handful, if that. At UCSF, they decided to compare ECCE with phaco, and found a similar complication rate. They therefore feel there is no ethical dilemma in exposing patients and resident surgeons to this technique instead of phaco. I agree- ECCE should not be a lost art… just yet.