The History of Cataract Surgery Cataracts have been a medical problem throughout history. In early times, strange concoctions and eye drops were used to treat cataracts until physicians in ancient Babylon and India began surgical treatment. Their highly primitive method, known as couching, involved using a sharp instrument to push the cloudy cataract lens to the back of the eye clearing the visual axis or line of sight. This method is still used in some parts of Africa today.
In the 18th century, surgeons progressed to making an incision in the eye to remove the entire cloudy lens instead of pushing it back into the eye. Surgeons initially tried replacing the natural cataractous lens with a small glass lens, but were unsuccessful. This made it necessary for patient’s glasses to have very thick lenses in order to see because the lens of the eye provides such a large portion of the power of the eye. Therefore, once the natural lens was removed, the only alternatives were to wear thick heavy glasses or contact lens.
By the 20th century, surgeons learned to remove only part of the cloudy lens and leave the outer clear capsule in the eye. Then during World War II British surgeons discovered that pieces of Plexiglas from a shattered canopy of a fighter plane, lodged in a pilots’ eye, did not cause any harmful reaction. That is, the material was not recognized by the body as a foreign substance causing an infection or inflammation. Using this light, plastic material, British surgeon Harold Ridley designed a lens that was successfully implanted in the clear capsule left behind. This made thick heavy glasses unnecessary after cataract surgery.
In 1968, American surgeon Charles Kelman adapted a new technology called phacoemulsification to remove cataracts. This sophisticated procedure uses ultrasound through a tiny probe to gently break up the cataract and remove it from the inside of the eye. Phacoemulsification is performed through a tiny 2-3mm incision that does not require stitches unlike previous methods that required much larger incisions and several stitches.
Cataract surgery was revolutionized when ultrasound and plastic lens implant technology were combined. Today, after decades of development, modern cataract surgery is considered one of the safest surgeries performed with millions of successful procedures completed yearly around the world. As of late last year, lasers can now be used to make incisions in the cornea and lens, as well as, soften the lens material to be removed.
Oklahoma is proud to have one of the first surgeons to actually use artificial lens implant technology. Dr. J. Harley Galusha from Tulsa, Oklahoma was introduced to implants while on a mission trip in Africa. After his trip he went to Europe and was able to acquire some of the implants that he successfully used on 5 patients in 1974. He was only the fourth surgeon in the United States to implant the lenses and since that time millions of implants with hundreds of different designs have been implanted. Lens implants used today are foldable, silicone or acrylic, can correct astigmatism, and in some cases are multifocal, similar to bifocal contact lens. These lens implants can be inserted through a micro-incision and do not require stitches. These techniques result in very rapid visual recovery and healing with little down time. Drops are used to avoid infection and swelling for 3-4 weeks after surgery at which time they are discontinued.
After cataract surgery, glasses are required to fine tune vision in the distance and almost always for reading. Patients who required thick lenses for high prescriptions prior to cataract surgery can enjoy thin light lenses afterwards because the majority of the power required is in the lens implant. Most patients can be fitted with glasses 4-6 weeks after surgery. At this point patients are dismissed for yearly eye health examinations.
If you have questions concerning cataracts or cataract surgery, please contact us in Stillwater at 405-372-1715 or Pawnee at 918-762-2573. We also invite you to visit our website at www.cockrelleyecare.com and like us on Facebook at Cockrell Eye Care Center!