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Year : 1988  |  Volume : 36  |  Issue : 4  |  Page : 149

High technology! At any cost?

CBM Oph. Institute, Little Flower Hospital, Angamally-683 572 Kerala, India

Correspondence Address:
Tony Fernandez
CBM Oph. Institute, Little Flower Hospital, Angamally-683 572 Kerala
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Fernandez T. High technology! At any cost?. Indian J Ophthalmol 1988;36:149

How to cite this URL:
Fernandez T. High technology! At any cost?. Indian J Ophthalmol [serial online] 1988 [cited 2021 Mar 5];36:149. Available from: https://www.ijo.in/text.asp?1988/36/4/149/26486

Gone are the days when the ophthalmic surgeons did cataract with a Grafe's knife - delivered the lens by tumbling method or forceps and put hack the conjuctiva without suture. The simple surgery for cataract was done within a minute or two, with the least expense and a few instruments. Majority of the patients had useful vision and the remaining blamed fate for whatever had happened.

Introduction of Zanalolysin and cryo extraction was quickly accepted by Indian ophthalmologists and this gave cataract extraction a new era of modernity. The concept of Phacoemulsification with ultrasound did not get wide acceptance because of its high cost and complications reported. Then came the revival of intra ocular lens implantation.

Intra ocular implants revolutionised the complete concept of cataract surgery. Iris supported lenses, Iridocapsular lenses, Anterior chamber lenses and Posterior chamber lenses - were extensively experimented in human eyes during the last decade.

Hundreds of designs were produced by different surgeons making the choice difficult for young upcoming surgeons. Intra ocular lenses opened up a huge market for the business community. It was found that there was a market for billions of dollars in lens manufacture. Aggressive salesmanship and unethical practices prevailed. Under developed countries were dumped with low quality and rejected lenses for the Western world. With active participation of unscruplous Indian businessmen,out dated models were supplied in India and even new labels were pasted over the old ones extending the expiry date.

Modem Extra Capsular Cataract Extraction needed expensive mic­roscopes. Late capsulotomy became a necessity in a good number (30°/0) of patients and the YAG LASER was introduced. Extra Capsular Extraction revived the use of phacoemulsification. Perhaps to justify this lenses which could be inserted through a small incision also was discovered. Thus the flexible lenses were horn. A simple cataract extraction with minimal instrumen­tation has now become a sophisticated surgery done with expensive instruments. The cost of such instruments needed for such a surgery varied from a million or two million. cost of a cataract surgery has also gone up and some times beyond the reach of the poor.

Quality of vision is a must. The scientists any: the ophthal­mologists should strive to achieve this goal. But doubts still linger - whether we are becoming the victims of the aggressive salesmanship of manufacturers of these highly sophisticated instruments. Is it not time we think of alternative methods to acheive these same goals without depending on such expensive and sophisticated equipment ?

I think this question is debatable. High technology! At any cost?


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