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We often hear how cataract surgery is becoming refractive surgery. In fact, cataract surgery became refractive surgery when Sir Harold Ridley implanted the first IOL. While cataract extraction provides an immediate benefit by clearing the optical media, the patient must rely on the refractive power of the IOL for the rest of his or her life. Getting that refractive power right falls within the purview of refractive surgery, and it involves more than inserting the IOL into the capsular bag.