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Cataract surgery has been attempted for many centuries. The process as we know it today is unrecognizable from the techniques of the past, but even the oldest were done with the same goal in mind—to prevent deterioration or loss of vision.
The evolution of the process is fascinating—if a little gruesome. To fully understand what the history is behind cataract surgery, we need to travel back to the 5th century BC, when a method called “couching” was used to try to prevent people going blind from the condition.
There is evidence of attempts to reduce cataract blindness as early as the 5th century BC. The procedure didn’t remove the cataract. Instead, it was pushed out of place using a needle. Because it no longer blocked the flow of light through the eye, there would have been an instant improvement in vision.
However, back then there was no knowledge of infection control, thus blindness or other serious conditions occurred soon afterward.
It wasn’t until the mid-1700s that new processes were explored. These involved cutting into the cornea, entering the lens capsule, and cutting out the lens. This was known as “extracapsular” as it involved removing the diseased lens from its natural capsule (extra = outside). As you can imagine back then, this caused a lot of tissue trauma. This, coupled with a lack of aseptic techniques and still relatively little knowledge about infection, led to issues with wound healing and infection.
However, it was deemed to be about 50% more successful than the couching procedure of old.
In the 19th century, a different technique was developed and used for a while. This involved removing the entire lens and lens capsule. The surgeon would make a large incision and, quite literally, push the whole cataract and surrounding capsule out of the eye with the thumb. However, the process caused a significant risk of eye trauma, slow healing, and other side effects.
In the 1970s, western countries generally replaced the procedure with ones more similar to those used today.
The late 1960s and early 1970s saw a technique—phacoemulsification—invented. This still forms the basis of today’s cutting-edge procedures, when a laser is used to break down the diseased lens, allowing the fragments to be gently aspirated from the eye.
Much research was carried out around ways to reduce the level of trauma caused to the eye during the procedure.
In the early 2000s, a new technology was introduced to laser vision correction (LASIK), whereby a corneal flap was made, rather than an incision. It was soon recognized that this could also be applied to cataract surgery, and in 2008 it was first performed in Budapest, Hungary. This is now commonplace in many advanced cataract surgery procedures today.
More recent advances include the evolution of intraocular lenses (IOLs). Rather than the traditional single-vision lens (still commonly in use today) new materials and technology means there are lenses that can provide clear vision at multiple distances. There are also ones that can correct astigmatism, work with the muscles of the eye to change focus, and even have the prescription changes while they remain in situ.
It’s thanks to the commitment of the surgeons of yesteryear that the cataract procedures of today exist. Surgeons, such as Brent Bellotte M.D., the lead clinician at the Modern Cataract Surgery Clinic, continue this incredible work, pushing boundaries and forever advancing surgery and IOL technology.
Discover more about why the clinic is considered one of the best in the US (if not the world) at https://www.moderncataractsurgery.com, and call our team today for more information.
