History of Cataract Surgery

Several philosophers have reminded us that those who forget the mistakes of the past are destined to repeat them in the future.In this historical survey, it is hoped that the knowledge we inherited will be an incentive for us to continue to strive to improve the quality of life of our patients.The earliest recorded ophthalmologic reference to be found dates back to Babylonia-Assyria (2250 B.c.) in the Code of Hammaurabi, which is a legal document concerned with civil laws administered by the Babylonian king, Hammurabi.The origin of the term cataract is interesting, but according to Celsus, I the term is logical because it means a waterfall or flowing down.It was believed that a cataract was an inspissated humor that had seeped from the brain into the space between the cornea and the iris.Rufus,2 the author of the earliest anatomy book (On Naming the Parts of the Human Body) was the first to use the term crystalline lens.Jacques Daviel 3 (Fig I ) started a revolution in ophthalmic surgery on April 8, 1747.A couching procedure failed, so through an inferior corneal incision, he inserted a needle behind the lens and delivered it with some loss of vitreous.This was the first report of cataract extraction from its normal position behind the iris.In 1753, he presented one of the landmark articles 4 in ophthalmic history to the Royal Academy of Surgery.He reported I 15 cataract extractions with 100 successes.By 1756, he had performed 434 extractions with only 50 failures.s Because Daviel opened the anterior capsule, this was an extracapsular extraction.It is remarkable that the intracapsular method was born during this same period.Samuel Sharp6 (1753) of London and George de la Faye 7 (1752) are credited with the first such procedures.Sharp expelled the lens from the eye by pressure of his thumb.Shortly thereafter, a more direct method was adopted by RichterB (1773), who pushed the lens out after impaling its posterior pole with a needle thrust through the sclera.This method was also used by Beer 9 and von Canstatt.lo A. and H. Pagenstecher ll • 12 (1866-1871) introduced the method of removing the lens with a spoon.