MODERN SURGERY FOR GLOBAL CATARACT BLINDNESS - PRELIMINARY CONSIDERATIONS

Unoperated cataract in the developing world remains ophthalmology's ma jor unsolved problem. Recent developments have brought into question t he assumptions of those who have thought that extracapsular surgery wi th implantation of a posterior chamber intraocular lens is an unrealis tic approach to the treatment of global cataract blindness. High-quali ty 1-piece posterior chamber intraocular lenses are being manufactured locally for approximately $10 each. Most ophthalmologists can be trai ned to perform extracapsular surgery in a 1-month course. This process is particularly effective if outstanding local surgeons receive inten sive training to become instructors. While the incidence and treatment of posterior capsule opacification requires further study, the develo pment of a low-cost YAG laser may be a solution. Imaginative ways to r ecover costs will need to be developed if the staggering prevalence of cataract blindness is to be effectively addressed. The improved resul t of modern surgery may make patients more willing to pay for their op eration.