Innovations in Eyecare: The History of Cataract Surgery

Innovations In Eyecare: The History of Cataract Surgery

By Thomas Byrd, MD 

Cataracts are a common problem people experience as they get older. It’s estimated that up to 25 million Americans are currently living with cataracts. These clouded lenses of the eye can be removed thanks to cataract surgery, which boasts a 98 percent success rate.

Modern cataract surgery has come a long way since its beginning. The team at our Detroit, MI vision center would like to consider the long and fascinating history of cataract surgery. It goes back more than 2000 years, starting with physicians in the ancient world.

Cataract Surgery in the Ancient Greece

Cataract surgery can be traced all the way back to Ancient Greece. In the 2nd century AD, the physician Galen of Pergamon used a needle-shaped instrument to remove a clouded lens of a patient’s eye. The Greek physician, surgeon, and philosopher had a relatively sophisticated understanding of the anatomy of the eye thanks to his work on humans and research on animals. Also in the 2nd century AD, Greek physician Antyllus is credited with creating a bronze instrument that allowed for oral suction of the clouded lens of the eye.

Cataract Surgery in Ancient India and China

In the 3rd century AD, couching was used in Ancient India to remove cataracts. This is a dangerous procedure, however. It involved dislodging the clouded lens with a sharp object. Roughly 70 percent of couching procedures ended in blindness. The Indian physician Sushruta spread this practice to other countries. Cataract surgery eventually found its way to China and experienced greater improvements during the Sui dynasty (581-618) and Tang Dynasty (618–907).

Cataract Surgery in the Islamic World

We can thank the Islamic world for preserving so many ancient texts from the ether of history. Many innovators in the Islamic world also contributed to innovations in eye care. Building on previous techniques in the Ancient world, 10th century Persian physician Muhammad ibn Zakariya al-Razi developed a cataract surgery technique that used Antyllus’ suction equipment. The 10th century Iraqi ophthalmologist Ammar Al-Mawsili performed a similar suction surgery. The 14th century Egypt oculist Al-Shadhili reported of a variation on the oral suction instrument; this device used a screw to produce suction instead.

Innovations in Cataract Surgery from the 1600s-1800s

A host of medical innovations were made during the 17th, 18th, and 19th centuries. Some highlights include:

  • 1611 - In the early Americas, there’s some speculation that cataract couching was performed around this time

  • 1748 - French ophthalmologist Jacques Daviel becomes the first modern European to successfully remove a cataract

  • 1815 - Philadelphia surgeon Philip Syng Physick uses an oral suction instrument to successfully remove a cataract

Development of the Intraocular Lens

In the 1940s, modern cataract surgery truly began. During this decade, English ophthalmologist Sir Nicholas Harold Lloyd Ridley developed the intraocular lens (IOL). This implantable replacement lens for cataract surgery patients improved overall vision quality after the procedure was performed.

Development of Phacoemulsification

In 1967, another key innovation in patient safety, comfort, and care was made. American ophthalmologist Charles D. Kelman developed phacoemulsification. This process uses safe ultrasonic waves to emulsify the crystalline lens. Now a cataract could be removed without a large incision.

Development of the Foldable IOL

In 1978, another material innovation was made that has helped cataract surgery enter a new, safer, small-incision era. The Chinese eye surgeon Kai-yi Zhou implanted the first foldable IOL. This allowed surgeons to place an intraocular lens using a small incision.

Contact an Experienced Eye Surgeon

For more information about treating cataracts and improving your vision, be sure to schedule an appointment today! We look forward to your visit and discussing the health of your eyes in greater detail.