The Early History of Cataract Surgery

Those considering cataract surgery right now may remember that cataract surgery was not always the easy, quick procedure it is today. Many people don’t realize just how long cataract surgery has been around (spoiler alert: a very long time.) Cataract surgery, just a few short years ago, involved a lengthy hospital stay and recovery. Today, cataract surgery is a short, routine procedure that allows patients to go home the same day. So, if only a few years ago cataract surgery was much different than it is now, what was it like at the beginning? Let’s find out!

Earliest Recorded Cataract Case

The earliest known case of cataract was recorded in a small 5th-century statue found in Egypt in 1860. This statue, made sometime around 457-2467 B.C., depicts a man with one white eye. This finding in a depiction of a grown man insinuates a mature cataract. A painting in the tomb of the master builder Ipwy at Thebes reveals an oculist treating the eye of a craftsman with a long surgical instrument.  These things confirm the fact that ancient Egyptians knew about cataracts and had a treatment: couching.

The Early Couching Technique

The earliest known form of cataract surgery is called couching. Certainly not for the faint of heart, the couching technique involved penetrating the eye with a long instrument and pushing the cataract out into the cavity of the eye. Because the eye no longer had a functioning lens, vision would be extremely blurry and in some cases, this treatment would cause blindness. Couching made it’s way to different parts of the world and continued to be used throughout the Middle Ages (it is still sometimes used in parts of Africa and Yemen.)

Medical Progress (Sorta)

The couching technique would eventually be replaced with cataract extraction surgery. During this method, the lens was removed through a hollow instrument using suction. These bronze oral suction instruments are thought to be used as early as the 2nd century A.C. This procedure required a large incision in the eye, a hollow instrument and someone with a large lung capacity. This procedure was largely not very effective.

The first person to successfully extract cataracts from the eye was a French ophthalmologist named Jacques Daviel. He performed the first extracapsular cataract extraction on April 8, 1747. Dr. Daviel, by performing this technique, paved the way for the modern cataract surgery we have today.

While the method of cataract extraction was taking hold, couching was still very prevalent during this time. One known coucher (or cataract surgeon), John Taylor (1703-1772), continued to perform this ineffective and dangerous method. In fact, he performed the couching technique on a number of famous people, two of particular note being famous German composers Johann Sebastian Bach (1685-1750) and George Frideric Händel (1685-1759). Bach, who was unwell and starting to go blind at the time of his surgery with John Taylor, went blind after the surgery and died four months later. Händel also lost his vision due to the procedure and lived out his last years blind.

Modern Cataract Surgery

With the advent of topical anesthesia, improvements in cataract surgery methods, and the invention of intraocular lenses and phacoemulsification, we have the cataract surgery we see today. Modern cataract surgery has an incredibly low complication rate and is much easier, quicker and effective today.

We’re thankful for the medical advances in cataract surgery that allows us to operate on patients safely and effectively. Here at Eye Physicians and Surgeons of Arizona, our cataract surgeons have performed thousands of successful cataract surgeries (no couching involved). If you’d like to schedule your cataract consultation to see if cataract surgery is right for you, contact Eye Physicians and Surgeons of Arizona today!

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