North America is the best place for cataract surgery, according to a new study.

Study authors evaluated adverse event rates and variations in surgical technique, during and after surgery, for 1,349 cataract surgery patients in the United States, Canada, Spain and Denmark. Phacoemulsification, with its smaller incision and quicker healing time, was performed in 67% of the American and Canadian procedures but in only 33% of the Danish procedures and 3% of Spanish ones.

American and Canadian doctors used local anesthesia 96% of the time, but their European counterparts used it only 62%, though surgical complications occur twice as often with general anesthesia. Overall, European physicians seem to be slower to adopt new medical technology.