Phacoemulsification--why?

When a new operation replaces an old, it must be better, not just equally good. The Kelman method of cataract extraction has given impressive results in patients under the age of 30 years. However, for senile cataracts it is not better, the hospital stay is not shortened, and the recovery time is directly proportional to the age of the patient and to the preoperative condition of the eye, not to the type of extraction. Phacoemulsification is a cataract extraction and, therefore, should receive exactly the same monetary reward. No comparative series of cases done by the same surgeon or surgeons of equal skill has demonstrated that the Kelman phacoemulsification procedure is accompanied by fewer retinal detachments, Irvine-Gass syndromes, or other postoperative complications. The Kelman phacoemulsification method should be an adjunct to, and not a replacement for, the current intracapsular cataract extraction.