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After being used regularly for centuries, couching has been mostly abandoned in favour of more effective techniques, due to its generally poor outcomes, and is currently only routinely practised in remote areas of developing countries. [11] [12] Cataract surgery was first mentioned in the Babylonian code of Hammurabi 1750 BCE. [13]
Cataract surgery by “couching” (lens depression) is one of the oldest surgical procedures. The technique involves using a sharp instrument to push the cloudy lens to the bottom of the eye. Perhaps this procedure is that which is mentioned in the articles of the Code of Hammurabi (ca. 1792–1750 BC) though it is a mere speculation.
Visual outcome after cataract surgery was close to conformity with WHO guidelines in Buenos Aires, where more than 80% of post-surgery eyes had visual acuity of 6/18 (20/60) or better, but ranged between 60% and 79% in most of the other regions, and was less than 60% in Guatemala and Peru. [126]
Posterior capsular opacification, also known as after-cataract, is a condition in which months or years after successful cataract surgery, vision deteriorates or problems with glare and light scattering recur, usually due to thickening of the back or posterior capsule surrounding the implanted lens, so-called 'posterior lens capsule opacification'.
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.
0.03–0.05% eye infection risk, which in worst case can lead to blindness. (This risk exists in all eye surgery procedures and is not unique to IOLs.) glaucoma, astigmatism, remaining near or far sightedness, rotation of the lens inside the eye one or two days after surgery.
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