Cataract blindness in the developing world: is there a solution?

Cataracts are the leading cause of blindness worldwide, accounting for half of the world's 40 million blind. The majority of the world's 20 million cataract blind live in the developing world. About 5 million new cases of cataract blindness occur each year. Only a small percentage of persons in the Third World who develop cataracts receive cataract surgery. Cataract blindness causes severe economic and social problems in these countries. Because of increased longevity and population growth in the Third World, the number of untreated cataract cases is escalating rapidly. Governmental, non-governmental and service club organizations have put extraordinary effort and resources into reversing the trend of increasing cataract blindness, but much work still needs to be done. Current surgical methods used in the Third World have not yet succeeded in reducing the backlog of cataracts, due in part to either their prohibitive cost or poor results. Extra capsular cataract extraction (ECCE) with placement of a posterior chamber intraocular lens (PC-IOL) is the hope for preferred method of treatment. This paper discusses a largely overlooked method of cataract surgery which may be an additional, cost-effective and efficacious means of providing good sight rehabilitation. Combining intracapsular cataract extraction, currently the most common method used in the rural developing world, with anterior chamber intraocular lens implantation (ICCE AC-IOL), may prove effective in reducing the cataract backlog in developing countries.