To the Editor.
—As expatriate ophthalmologists working in Africa, we read with interest the articles by Ruit et al1 and Egbert and Buchanan2 on extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) insertion.We were not surprised to read of a vitreous loss in 10% of the patients in the Ghana study. We reviewed the last 97 ECCEs for senile cataract that we performed in the Queen Elizabeth Central Hospital (Blantyre, Malawi). We used a microscope and a manual irrigation-aspiration technique, without viscoelastics, in these procedures and found that we lost vitreous in 11% of the patients. Some vitreous loss may be attributable to improvisations necessary in developing countries. However, differences in the cataracts in these populations compared with cataracts in developed countries deserve consideration.First, the lens capsules are different. Eighty-seven of our patients (90%) had visual acuity of light perception only. Most of these
Lewallen S, LeMeasurier RT. Extracapsular Cataract Extraction in Developing Countries. Arch Ophthalmol. 1993;111(1):18. doi:10.1001/archopht.1993.01090010020004