We recently celebrated our 50th anniversary, and while reflecting on our own history of service, we decided to share the history of one of our main areas of specialty: cataracts.
When were Cataracts First Discovered?
According to research presented by Unite for Sight, “The word ‘cataract’ stems from the Greek word for ‘waterfall,’ because prior to the 1700s, people believed that cataracts were comprised of an ‘opaque material flowing, like a waterfall, into the eye.’”
Though it’s still not clear exactly when or where cataracts were first discovered, a complete table of early instruments for cataract surgery included in a paper published in the Annals of Translational Medicine in November 2020 catalogues tools dating as far back as the first or early second century CE.
These same researchers have determined that a 9th century Indian manuscript of the Suśrutasaṃhitā may be the very first to describe cataract surgery, and that early Romans and Egyptians may also have developed treatments for the same condition. So while we may not know the precise origins, cataracts — and the desire to treat them — have been around for at least centuries and perhaps millenia.
Early Forms of Treatment
Cataract Couching
During the early days of eye surgery, cataracts were treated with a technique called couching. This procedure was usually performed after the lens had become completely rigid and opaque. A sharp tool was then used to dislocate the lens, shifting it into the cavity at the back of the eye. Patients were given limited, unfocused vision, and for obvious reasons the procedure was dangerous, and remains so in areas where it is still practiced.
Extra- and Intracapsular Extraction
French surgeon Jacques Daviel is credited with the first performance of an extracapsular surgery in 1747. This procedure involved making an incision in the cornea, and extracting the affected lens with a small, spoon-shaped instrument (called a curette), while leaving the back of the lens capsule intact. “Although this procedure represented great progress compared to couching,” Geetha Davis, MD points out, “postoperative complications were considerable, including poor wound healing, retained lens remnants, posterior capsular opacification, and infection.”
The first intracapsular extraction is credited to Samuel Sharp in 1753, who removed the entire lens, including its capsule. But some research has indicated more wound-related complications in intracapsular extractions, possibly because a larger incision is required.
Phacoemulsification and Intraocular Lenses
Still used today as the basis of common cataract surgery, phacoemulsification implements ultrasonography to break up the affected lens so that it can be replaced with an artificial, intraocular lens. Though intraocular lenses were introduced by Sir Harold Ridley in 1949, it wasn’t until 1967 when Dr. Charles Kelman used them in combination with this more high-tech procedure. Thanks to technological advances, intraocular lenses have now become foldable, which means a smaller incision has to be made for insertion.
Modern Cataract Treatment
New breakthroughs in technology and research continue to rapidly improve cataract treatment year after year. Laser surgery is also now available, and within only the last ten years, innovations in this method have helped surgeons improve the technique even more.
As recently as May 2021, new research has also been published around how our eyes develop in gestation, which may completely revolutionize cataract treatment as we know it.
At Eye Consultants of Atlanta, our specialists are staying on top of these state-of-the-art developments to give you highly-customized, precise results with minimal recovery time. Reach out to make an appointment online, or schedule a consult by calling (404) 351-2220.