The Origins of Cataract Surgery

[caption id="attachment_16769" align="alignleft" width="1024"] David Spalton delivering the 2019 ESCRS Heritage Lecture[/caption] “If a physician … open a tumour (over the eye) with an operating knife, and saves the eye, he shall receive ten shekels…” – Code of Hammurabi, Mesopotamia, 1750 BCE. References to cataracts and ocular surgery date back to antiquity, and couching cataracts – pushing the lens out of the capsular bag to restore light perception – has been practiced the world over. But breakthroughs in understanding the anatomy and physiology of sight in the 16th and 17th Centuries paved the way for Jaques Daviel to perform his first successful cataract extraction in 1747, said David Spalton FRCS, FRCP, FRCOphth at the ESCRS Heritage Lecture 2019 “The Origins of Cataract Surgery”. Using instruments remarkably similar to today’s, by 1756 Daviel reported 434 extractions with 88% successful, a marked improvement over couching, Dr Spalton said. Refinements accelerated through the 19th Century, with development of foundational surgical techniques by Albrecht von Graefe, and anaesthesia. Invention of the intraocular lens by Sir Harold Ridley and phacoemulsification by Charles Kelman MD were the other two key developments that made cataract surgery the most widely performed and highly successful procedure it is today. “Many surgeons have made great contributions, but Daviel was the first of the four great pioneering surgeons,” Dr Spalton concluded.

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