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Not too long ago the most difficult part of a cataract operation was the successful removal of the lens in its intact capsule. Today, because of the greater opportunity to do more cataract surgery, improved methods and drugs for local anesthesia, and bolder corneal-scleral suturing, intracapsular extractions are the rule. Iris prolapse is infrequently seen, and vitreous loss is relatively rare. House Officers may go through an entire residency and see scarcely a case of vitreous loss.
All this has tended to subordinate the operation itself and make the surgeon more daring. It is frequent that eyes with 20/70 vision are subjected to operation, and some surgeons do not hesitate to operate on eyes with 20/40 vision.
The difficult phase is now the patient. Too often 20/20 aphakic vision is a 20/20 cripple. Before surgery 20/50 or 20/70 may have been enough for the patient to pursue a normal life.