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Demystifying Eye Health Evolution of Cataract Surgery I

The oldest recorded incidence of cataracts was documented in a statue unearthed in Egypt from the 5th dynasty (about 2460 B.C.). A statue of a priest exhibited an obvious white pupil in one eye representing a mature cataract.

Michael Willman, DO

“Couching” was the primary surgical technique to treat cataracts. It involved taking a sharp metal instrument and inserting it into the eye to pry the cataract back into the eyeball. Many past cultures have evidence of couching being used to treat cataracts, including India, China, and Babylonia.

The procedure was first written about in a text in India around 800 B.C. Via trade routes, the technique spread across the globe. Later, couching was replaced by a procedure to actually remove the lens from the eye, rather than leave it in the eye. A 2nd century Greek physician,

Antyllus, was known to remove the cataractous lens of the eye with suction from a bronze tube from the surgeon’s mouth. However, these rudimentary procedures were fraught with complications, blindness, infection, and even death.

However, couching still existed until the late 18th century with no-table patients undergoing this procedure such as composers Johann Sebastian Bach and George Frederick Handel. Treatment continued to evolve until the first version of modern cataract surgery was performed on April 18th, 1747 by French ophthalmologist Jacques Daviel. His technique of “extracapsular cataract surgery” is what modern cataract surgery is based upon.

It was the first significant advance in cataract surgery since couching. Until the 1970’s, a patient undergoing cataract surgery needed very thick glasses afterwards and had to endure a long postoperative healing period for weeks. Two advances in the last half of the 20th century ushered in the modern era for cataract surgery with the use of pseudophakic intraocular lens (IOL’s) and small incision phacoemulsification surgery (phaco). Two pioneers of medicine helped to make cataract surgery what it is today: Sir Harold Ridley from England and Dr. Charles Kelman from the U.S.

If your vision is bothersome contact CarlinVision at 770.979.2020 or visit CarlinVision.com. Board-Certified Ophthalmologists can determine the reason you are not seeing as clearly as you should. 

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