Cataracts are an incredibly common condition. Half of all patients over the age of 60, not 80, have cataracts. They aren’t a new condition either – historical records document the existence of cataracts around the globe since ancient times. Because this condition is common and leads to obscured vision or blindness, doctors and healers throughout history have attempted to treat cataracts and restore vision. Cataract surgery has seen a remarkable evolution and today is capable of completely restoring vision.
Sanskrit manuscripts record the earliest known form of cataract surgery. Referred to as “couching,” this form of cataract removal was performed as early as the 5th century BCE. During this procedure, the physician would dislocate the affected lens. Using blunt force, the lens would slide from its position behind the pupil and be contained further back in the vitreous cavity. The dislocation of the clouded lens allowed light to enter the eye, but without an operational lens, patients were unable to focus on images and experience very blurry vision.
Archeological evidence from the 1st century AD indicates that physicians in Iran, Greece, and Egypt used specialized instruments to remove cataracts by slicing them into tiny pieces so the body could more easily absorb them. This technique, called “needling,” would have had the same end result as couching.
In 1748, the French physician Jacque Daniel demonstrated the successful removal of a cataract from the eye. During the procedure, he removed the clouded lens, but left the outer covering (the lens capsule) intact. Without an intraocular lens, the patient would still have unfocused vision, but they had a much lower risk of infection and other side effects using this approach.
By the early 1900s, doctors had developed specialized forceps and suctions cups that allowed them to remove the entire lens more carefully and precisely. By the 1960s, lens removal had become a very reliable and safe procedure. Despite lens removal being considered “successful,” patients were still unable to see clearly after surgery.
A major evolution in cataract surgery occurred with the development of intraocular lenses (IOLs). During World War II, British ophthalmologist Harold Ridley noticed that fighter pilots who had splinters of acrylic plastic in their eyes did not experience an inflammatory reaction, as was seen with glass splinters. This gave him the idea to create a plastic artificial lens that could be implanted in the eye during cataract surgery. The creation of the world’s first IOL paved the way for modern cataract surgery, which involves the extraction of the clouded lens and the implantation of an intraocular lens, which effectively restores vision. Without the development of IOLs, cataract surgery would never have become as successful and widely performed as it is today.
Since the invention of IOLs, additional developments have contributed to cataract surgery becoming the extremely safe, effective, and comfortable surgery that it is today. These advancements include:
Given the way that cataract surgery has evolved since ancient times and throughout modern medical history, we have no doubt that it will continue to change and advance in the future. Our promise to you is that we will always be on the cutting edge of the latest technologies available in cataract surgery. We will continue to research, test, and embrace new technology as it is proven safe and effective.
We serve patients in Huntington Beach, Long Beach, Irvine, and Newport Beach, as well as other Orange County and Los Angeles communities including Fountain Valley, Westminster, and Costa Mesa.