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I appreciate the opportunity to respond to the letters of both Dr Perlstein and Dr Williams commenting on my reply in The Journal.I am afraid both gentlemen missed the point! The original question was whether to recommend phacoemulsification for the right eye in this elderly patient, and I was merely trying to point out that phacoemulsification was contraindicated.I furthermore did not state exclusively that the patient should be operated on and fitted with an extended-wear contact lens. The statement says that I would recommend either an extended-wear lens or a pair of improved cataract glasses. Both alternatives were offered. I furthermore stated that the cataract should be removed by either the intracapsular or extracapsular route, as contrasted with phacoemulsification. I did not intend to get into a discussion as to whether the intracapsular or extracapsular route was the safer of the two. It may well be
Hartstein J. Retinal Detachment After Cataract Removal-Reply. JAMA. 1983;250(16):2109–2110. doi:10.1001/jama.1983.03340160013011
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