A change in indications for cataract surgery? A 10 year comparative epidemiologic study

A change in the indications for cataract surgery might be one of the many reasons for the steady increasing number of cataract extractions. A comparison between the indications for surgery in a group of cataract patients from 1970 and a similar group from 1980 was done. In bilateral cataracts, evaluated on basis of visual acuity in both eyes, no widening of the indications for cataract surgery could be found. In monaphakics, going to be operated on the second eye, visual acuity in both eyes revealed no change, but we do operate more second eye cataracts now, 41% against 25% in 1970, which means that monaphakia is in itself considered a stronger indication for surgery in the second eye than it was 10 years ago. Acknowledgment of the difficulties of being monaphakic, refinements of extraction techniques and increased requirements for better vision among the elderly population might explain this altered attitude towards monaphakia.