Age-related cataract is the single most important cause of reversible visual impairment. It has been estimated that about half of all patients in their seventies will have a signifi cant cataract and by their nineties, almost everyone will be affected. One of the consequences, therefore, of the demographic shift towards old age that we are witnessing in the population of the Western world is an increase in the amount of cataract. The only effective treatment for cataract remains surgical and involves the removal of opacifi ed crystalline lens fi bres and replacement with an artifi cial intraocular lens, if at all possible.
Cataract surgery is already the most common surgical procedure carried out in the developed world, with over 300,000 operations performed by the NHS alone in the year 2005–20062. This number is set to increase in the future with a greater recognition of unmet need and escalating patient expectation as surgical techniques improve. This presents a challenge to both healthcare professionals to deliver high quality care, and to healthcare policy decision-makers who must target limited resources to maximum benefi t.