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Cataract surgery and IOL implantation have the safest and highest success rates of any eye care-related procedures. As with any type of surgery, however, some level of risk remains. [7] Most complications of cataract surgery do not result in long-term visual impairment, but some severe complications can lead to irreversible blindness. [90]
One-third of the patients pay the full US$100 for a complete work-up, modern cataract surgery, and all post-operative care. [5] Twenty percent of the patients pay a smaller amount based on what they are able to pay. The remaining third of the patients receive the cataract surgical care entirely free.
Cataract-surgery coverage widely varied across Latin America, ranging from 15% in El Salvador, to 77% in Uruguay. Barriers cited included cost of surgery and lack of awareness about available surgical treatment. The number of available ophthalmologists appeared to be adequate, but the number of those who practised eye surgery was unknown. [31]
The cataract is removed from the capsule and anterior chamber using hydroexpression [Note 3] viscoexpression, [Note 4] or more-direct mechanical methods. [4] [13] [14] The extraction of the cataract must be done with due care so as not to compromise the integrity of the tunnel; the endothelium and capsule are also vulnerable to injury.
Archaeological evidence of eye surgery in the Roman era also exists. [78] Galen of Pergamon (ca. 2nd century CE), a prominent Greek physician, surgeon and philosopher, performed an operation similar to modern cataract surgery. Using a needle-shaped instrument, Galen attempted to remove the cataract-affected lens of the eye. [79]
This method of surgery reduced the need for an extended hospital stay and made out-patient surgery the standard. Patients who undergo cataract surgery rarely complain of pain or discomfort during the procedure, although those who have topical anaesthesia, rather than peribulbar block anaesthesia, may experience some discomfort. [8]
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