The History of Modern Cataract Surgery

Surely the threat of blindness from whatever cause, is an event faced by an ever-growing segment of our aging population. However, when the cause was cataract formation, over the centuries a definite treatment evolved and became available to help those afflicted with this problem, from couching, through crude extra-capsular Graeffe knife extraction, intra-capsular cataract surgery, and planned extra-capsular surgery, to phacoemulsification (ultrasound or laser). Doctors, therefore, recognized very early that there was one blinding condition which could be treated and in which vision could be improved. It is probably this operation that gave rise to ophthalmology as the first surgical subspecialty. In the same way that Alexander Flemming accidentally discovered the mould producing penicilinase, during the Second World War Harold Ridley identified an inert plastic monomer substance that could take the place of the human lens in the human eye, and appeared to cause no secondary side-effects. However the Ridley lens combines with the extracapsular surgery of the time, proved to be an unsatisfactory technique for the cataract patient. It was Cornelius Binkhorst from the Netherlands who proposed a more satisfactory fixation device, first to the iris pupil and then to the posterior capsule. At the same time, Peter Choyce refined the anterior chamber lens to create a stable replacement treatment the crystalline lens. This book, written and edited by two of the world's most eminent eye surgeons, traces the historical events that have brought us to what is now current thought for the present millennium. Foreword Preface - History of cataract surgery The four eras in the evolution of cataract surgery Intraocular lens implantation - The beginnings Cataract surgery (1920-1960) Pseudophakia: Intracapsular or extracapsular technique? History of the operating microscope Anterior chamber intraocular implants and intracapsular cataract surgery Manual extracapsular surgery Cryocataract surgery The 'Sputnik' intraocular lens Viscoelastics History of phacoemulsification Posterior chamber lens implantation The genesis of the posterior chamber lens-implant Phacosection: The evolution of a manual small incision-no-stitch-phacofragmentation cataract extraction technique Infantile cataract surgery - Evolution of modem techniques The early use of lens implants in children Secondery implantation History of the picosecoAd YAG laser The history of IOL power calculation in North America Intraocular lenses in visual rehabilitation of patients with macular disease Intraocular lens complications Teaching courses - 1967-1983 An Atlas of Ophthalmic Surgery Index of authors