Changing indications for cataract surgery.

Despite the fact that two community-based surgeons switched from routine intracapsular cataract extraction to planned extracapsular cataract surgery and routine implantation of posterior chamber lenses, they did not materially increase the size of their surgical load or change their indications for cataract surgery. In contrast a similar change in surgical technique by two high-referral hospital-based surgeons was associated with a marked increase in operative rates and increased preoperative acuity. A significant proportion of this change appeared to represent reduced reluctance toward monocular cataract surgery. By eliminating the aniseikonia of monocular aphakic and visual distortion of aphakic spectacle correction, use of IOLs appears to have contributed to changing indications for cataract surgery among some ophthalmologists. A larger, more comprehensive study would be needed to determine the full extent of these trends.