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—Drs Lewallen and LeMeasurier address many important topics that deserve further emphasis and comment. They ask whether there is a genetic difference between the types of cataracts seen in developing and developed countries. No available data can answer this question. Our article does not deal with the patients with 20/50 cataracts who many surgeons in developing countries operate on. Over half of our patients had best corrected preoperative visual acuities of less than 20/400 and 17% had acuities of light perception. This distribution is similar to what Drs Lewallen and LeMeasurier describe.We too have observed the following important qualities of the lenses in patients with mature cataracts. The anterior capsule has a varying degree of elasticity. It is often tough and leathery; often it is calcified. The posterior capsule frequently exhibits similar characteristics. There are varying degrees of adhesion between the perinuclear cortex and nucleus. The nucleus
Ruit S, Robin AL, Pokhrel RP, Sharma A, DeFaller J. Extracapsular Cataract Extraction in Developing Countries-Reply. Arch Ophthalmol. 1993;111(1):18-19. doi:10.1001/archopht.1993.01090010020005