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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 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]
Cataract surgery by phacoemulsification is frequently performed under surface anaesthesia. Facial nerve, which supplies the orbicularis oculi muscle, is blocked in addition for intraocular surgeries. Topical anaesthesia is known to cause endothelial and epithelial toxicity, allergy and surface keratopathy. [citation needed]
Manual small incision cataract surgery (MSICS) is an evolution of extracapsular cataract extraction (ECCE); the lens is removed from the eye through a self-sealing scleral tunnel wound. A well-constructed scleral tunnel is held closed by internal pressure, is watertight, and does not require suturing.
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]
"Couching for cataract"; Wellcome Collection illustration of Indian doctors performing the technique. Couching is the earliest documented form of cataract surgery. It involves dislodging the lens of the eye, thus removing the cloudiness caused by the cataract. Couching was a precursor to modern cataract surgery and pars plana vitrectomy.
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