The effect of technology on the indications for cataract surgery

Before the introduction of modern ophthalmic surgical technology following World War II, cataract extraction was easier and safer to perform if the ca taract was far advanced (mature) and both eyes were involved. The surgeon w as constrained from early surgery by the frequency of severe complications, the long convalescent period, and the distortions of aphakic glasses. Now it is easier to perform phacoemulsification and implant lenses in the early stages of cataract formation when the nucleus is soft and the posterior le ns capsule has not been weakened with age. Also, modern small-incision extr acapsular cataract extraction has a low rate of complications and a short c onvalescent period. It is feasible to extract a clear lens or one with mini mal opacifications and have a grateful patient. The surgeon is capable of i mproving the refractive state of the eye by selecting the power of the intr aocular lens. These facts have led to instances where cataracts have been e xtracted that were responsible for minimal or no symptoms.