Clinical examination of 113 patients in South Korea with lepromatous leprosy and severe visual impairment showed that the main cause of visual loss was the combined effect of corneal and lens opacities associated with small nonreacting pupils and iris atrophy. Cataract surgery with broad iridectomy and inferior sphincterotomy offers these patients with chronic lepromatous complications the best chance of preserving vision. Eighty-one cataract operations were performed under local anaesthesia, and in 90% vision improved; in 60% this improvement was 2 Snellen's lines or more.
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