A FEW YEARS AGO, it was common for speakers at continuing medical education meetings to ask for a show of hands in response to the following questions:
"How many of you perform refractive surgery?" (Approximately 10% of the hands go up.)
"How many of you perform cataract extraction and intraocular lens implantation?" (Almost all hands are raised.)
"Well in fact," says the speaker, "all of you who perform cataract surgery are actually performing the most common refractive surgical procedure."
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This exercise, meant to drive home the important refractive implications of cataract surgery, would be as valid today, because optimistic projections of millions of people with myopia electing to undergo laser photorefractive keratectomy (PRK) have yet to be realized.
More and more, our patients take the "miracle" of modern small-incision cataract extraction and intraocular lens (IOL) implantation for granted. "The surgery is very simple, isn't it?" they
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