History of cataract surgery Cataract surgery has been performed for many centuries. Interestingly, instruments for cataract surgery dating back to the ancient Roman times have now been discovered by archaeologists. Fortunately, there have been incredible improvements in cataract surgery since that time, especially in the latter half of the 20th century. In ancient Rome, hollow needles were used to break up the cataract, suction applied and the cataract removed. Unfortunately for the ancient Romans, no synthetic replacement lenses were available - leaving the patient with very blurry vision. However, the evolution of cataract surgery took a giant step forward in 1949, when an English eye doctor, Harold Ridley, developed and implanted the first intraocular lens (IOL). This lens was designed to imitate the natural human lens and was made of a hard plastic called Plexiglas. Today, cataract surgery still involves the removal of the cataractous lens and is primarily done using a procedure called "phacoemulsification". Again a small hollow needle is used, but nowadays the cataractous lens is broken up by ultrasound and gently removed by suction. With the advances in the development of polymers since 1949 a range of materials have been used to make IOLs. Today the most widely used IOL materials include polymethylmethacrylate (PMMA), silicone and more recently a soft, foldable acrylic material called AcrySof®. The PMMA and AcrySof lenses have similar properties with one major difference - PMMA forms a rigid lens while AcrySof lenses are flexible. This means that AcrySof can be folded and then inserted into the eye through a smaller incision. Importantly these smaller incisions often do not require sutures. While silicone lenses were the first foldable lens, AcrySof was the first foldable material that was specifically designed for use as an IOL. AcrySof lenses are now used extensively in cataract procedures worldwide. |
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Who may need cataract surgery? A cataract is a clouding of the normally clear, natural crystalline lens in the eye. This clouding is due to the aging process, but can also be caused by eye trauma, diabetes, some medications or be hereditary. Whatever the cause, cataracts typically result in blurred or fuzzy vision and sensitivity to light. Cataract formation occurs at different rates and can affect one or both eyes at the same time. Fortunately, with modern medical technology, cataracts can be effectively treated through the use of microsurgical techniques. In fact, cataract surgery is one of the most successful surgical procedures performed today - about 95% of all cataract surgery results in an improvement in vision. The best way to treat a cataract is to remove the cloudy lens and replace it with a new, clear artificial lens. This can be accomplished in two ways. The first technique is called "extracapsular extraction" (ECCE) and involves removing the cloudy lens in one piece. This technique requires a relatively large incision of 10-12 mm in length. The second technique is the latest advance in cataract removal. It is called "phacoemulsification" or "phaco" for short. In phaco surgery, a small ultrasonic probe is inserted into the eye. This probe breaks (emulsifies) the cloudy lens into tiny pieces. These pieces are then removed by suction from the eye. Phaco requires a small incision of only 3.2 mm or less. In the event that you require cataract surgery, your surgeon will determine which method is most appropriate for your condition. Source: Data on file, Alcon Laboratories., Inc. |
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