We examined retrospectively a total of 171 patients (236 eyes) who had undergone extracapsular cataract extraction (ECCE) with or without intraocular lens implantation (IOL). The best and practically corrected visual acuities were determined 6 months after surgery. Practically corrected visual acuity of the ECCE group was significantly worse than that of ECCE plus IOL group of patients who had undergone unilateral cataract surgery. In patients who had undergone bilateral surgery, visual improvement was almost optimal in both groups. With regard to practically corrected visual acuity, ECCE plus IOL was the preferable procedure for elderly patients who had had unilateral cataract.