It might be hard to believe, but cataract surgery is one of the oldest procedures ever recorded, possibly dating back to before 1200 BC. A painting found in a tomb in Ancient Egypt shows an oculist treating the eye of a builder with a long needle-like instrument. The length of the tool gives us reason to believe that it was used as an early method of cataract surgery called “couching.” The needle was used to push the clouded lens to the bottom of the eye, hopefully restoring vision.
The Early Years Of Cataract Surgery
The oldest surgical tools found in Egypt date back 4000 years and include the long slender needles used for couching. The method of couching spread through the world as evidence has been found that the operation was performed in Mesopotamia, India, Greece, China, and other ancient civilizations. Sometimes a curved needle was used instead of a straight one, but the method remained the same, push the cloudy lens aside. Even as a relatively simple surgical procedure, it’s incredible to think about the skill these ancient surgeons had!
Complications from couching were, however, common. Many patients ended up with only part of their vision restored or ended up completely blind. Couching was the primary cataract surgery for thousands of years up until 1747 when Jacques Daviel of France performed the first successful cataract extraction of the modern day.
The Evolution Of Cataract Surgery
Cataract extraction surgery involves making an incision in the eye. The lens could then be removed with a hollow suction instrument. Hollow tools for this method of extraction date back as far as the 2nd century A.C. Back then, an assistant with a strong lung capacity would provide the suction needed to remove the cataract lens. The success rate of this primitive procedure is not clear
Credit for the first successful cataract extraction is given to Jacques Daviel of France who performed successful surgery on April 8th, 1747. The benefit of extraction over couching is that it prevents the lens from shifting back into place, which could happen with the couching method.
The new cataract surgery created competition between the two procedures, yet neither was devoid of complications. Famous German composer Johann Sebastian Bach had the couching method performed on him in the mid-1700s, but ended up becoming blind and dying four months post-op.
Cataracts surgery remained primitive until the mid 20th century.
Modern Day Intraocular Lenses
Sir Nicholas Harold Lloyd Ridley, an English ophthalmologist, was dissatisfied by the current state of cataracts surgeries. With the disease affecting so many people, there had to be a better way to treat it. The inspiration for intraocular lenses (IOL) came from the comment of a medical student that said it was a pity they couldn’t replace the extracted cataract lens with a clear one. And with that, Sir Nicholas began researching replacement lenses.
He first needed to find a material that the human body wouldn’t reject. As a surgeon during the second world war, he found himself treating British Royal Air Force pilots that sustained eye injuries. When bullets struck the canopies of the pilot’s planes, shards of polymethylmethacrylate (PMMA), of which the canopies were made, shattered and became embedded in their eyes. Sir Nicholas observed that this PMMA material wasn’t being rejected by their bodies, and was therefore compatible with our ocular systems.
During the 1940’s he introduced the concept of intraocular lens (IOL) replacement for cataract surgery and on November 29th, 1949, implanted the first IOL in history. Today IOL cataract surgery is the most common eye surgery on the planet.
Cataract Surgery Today
Now, we’ve taken Sir Nicholas’ idea of an IOL to the next level. Not only can we use an artificial lens to correct your cataracts, but we can also to fix any existing prescriptions, solving two problems at once. These premium lenses are not covered by the provincial health care plan, and you’ll also be able to skip month long wait periods. We have certainly come a long way since Ancient Egypt. Schedule a free consultation for your cataract surgery with BoydVision by sending us a message or giving us a call at 604.430.9560.