We retrospectively studied 330 consecutive cases, comparing the incidence of posterior capsule opacification after 279 extracapsular cataract extractions (ECCEs) or phacoemulsifications and posterior chamber intraocular lens (PC-IOL) insertions, with the incidence of opacification following 51 combined corneal transplantations, cataract extractions, and PC-IOL insertions (ie, triple procedures). Opacification developed less frequently following the triple procedure than after cataract extraction alone (9.8% vs 36.2%, respectively; P < .001). Opacification also developed later following the triple procedure. The mean length of time before capsular opacification after cataract extraction alone was 24.3 months, while a mean of 45.6 months elapsed before opacification developed after the triple procedures (P < .05). Delineation of the mechanisms contributing to these outcome differences may provide a means of reducing the incidence of or preventing posterior capsule opacification after cataract surgery.