From a very primitive procedure to a very effective one today with optimum results, cataract surgery has advanced quite significantly over the years. Here is a look at the advances in cataract surgery and what makes today’s cataract surgery with intraocular lenses highly effective in correcting presbyopia, astigmatism, and refractive error.
Couching
Cataract surgery is one of the oldest recorded, and one of the most common, medical procedures. The first recorded cataract surgery was in India in 500 BC. The procedure was done by pushing the vitreous cavity using a needle to allow for better vision. This technique was used through the 1700s and was used by many countries, both east and west. Although the procedure is relatively simple, infections and complications were quite common occurrences during those days.
Lens Extraction
Couching was eventually replaced by lens extraction. The procedure was developed by Jacques Daviel in 1747. Instead of pushing or displacing the lens, in his paper Jacques Daviel explained how extracting the lens is more effective. With the development of surgical instruments and with the availability of local anesthesia, lens extraction was improved over the years until the early 20th century. By the mid-20th century, it was the standard treatment for people with cataracts. Patients had to wear contact lenses or high power hyperopic “Coke bottle” glasses since their eyes no longer have lenses. Although the vision is clearer than with the couching method, patient’s peripheral visions are distorted.
Intraocular Lens (IOL)
Intraocular lens is not something new. As far back as 1795 doctors already tried placing glass lenses during lens extraction surgery. However, it was only in 1949 when Sir Harold Ridley developed the polymethylmethacrylate lens that the procedure became successful. Prior to this, the glasses got dislocated in the eye. Nevertheless even with polymethylmethacrylate, lens complications occurred that doctors often did not recommend this option to patients.
Advances in intraocular lenses occurred from the late 1970s to the 1980s. The development of phacoemulsification significantly improved outcomes for cataract IOL surgery because it is now possible to make an incision of only 3mm. Moreover, with advances in surgical instruments, it has been made possible to remove the proinflammatory lens cortical material and insert the IOLs with less risk and less complications. In other words, it was the start of a less invasive cataract procedure with IOL.
LASIK Procedure
When the excimer laser was developed, cataract surgery advanced even further. Excimer can be used in LASIK surgery and photorefractive keratectomy. LASIK offers more effective correction, not to mention it is safer. With LASIK surgery the surgeon makes an accurate incision in terms of depth and size to access the cataract and accurately place the IOL. This results in a better visual outcomes as well as recovery.
References:
http://www.allaboutvision.com/conditions/laser-cataract-surgery.htm
http://www.minnesotamedicine.com/Past-Issues/Past-Issues-2009/June-2009/Clinical-Reeves-June-2009
Sugarland Eye & Laser Center leads in providing premium LASIK technologies to Houston, Sugar Land, and the surrounding region. The Center’s award-winning medical director introduced revolutionary technologies such as iLASIK to the region. This technology is used by NASA astronauts, Navy SEALS and Air Force fighter pilots. At Sugarland Eye & Laser Center, you can now receive the same treatment. For more information, please call (281) 240-0478 or visit us at www.houston-lasik.com.
About the Author
Amjad Khokhar, M.D. is Chief LASIK Surgeon at Sugarland Eye & Laser Center. Add Dr. Khokhar on Google+ here.
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