Postcataract Extraction Ischemic Optic Neuropathy

To the Editor.  —Hayreh,¹ in 1980, distinguished two types of postcataract extraction ischemic optic neuropathy. One type occurred in the immediate postoperative period, which he attributed to increased intraocular tension (and for which he, therefore, suggested prophylactic measures). The other type occurred after a period of good vision, and he considered it unrelated to the cataract extraction. He stated that Carroll's² view, connecting it to the cataract extraction, was "erroneous." We believe this statement is not justified.Carroll² had pointed out that the incidence of similar involvement of the second eye after cataract surgery was approximately 50% and that (as is still true) no patient was known to have had ischemic optic neuropathy occur in the second eye unless he had undergone cataract surgery.We believe the similar time of occurrence of ischemic optic neuropathy after the cataract extraction in each eye in a patient described by