subject: Advancements In Intraocular Lens Treatment [print this page] It would be tempting to believe that the wonders of eye correction surgery are relatively new, and can be marked down as a modern medical miracle. But this is not actually true, with the long history of eye treatment stretching back millennia. As is typical with all things medical, the road to the modern surgical procedures has been long and arduous. However, while cataract surgery was being performed thousands of years ago, intraocular lens treatment is only 60 years old. Needless to say, there have been advances made since those early years, partly through the design of intraocular lenses, complications avoidance through improved techniques and higher quality aftercare. An Ancient History It may come as something of a shock to learn that the idea of eye surgery extends to the 6th century BC. The leading civilisation at the time was in India, where mathematics, science and medicine were far above the comparable civilisations in Europe and the Middle East. At that time, the first reference to cataract surgery was made, with the physician Sushrute describing a procedure known as couching in his book Sushruta Samhita. Couching involved pushing the cataract lens into the eye ball, out of the field of vision, however, even Sushrute himself advised that the procedure should not be attempted unless it was completely necessary. Some 600 years later, the same procedure was referred to in manuscripts from Greece. Couching was not exactly effective in restoring sight, though no less effective than the alternative procedure of the time, which removed the cataract lens through suction. This technique is known to have been used as early as the 2nd century AD, with a 10th century Persian ophthalmologist Ammar Ibn Zakaiya alRazi describing it in detail.
The Catalyst Ancient procedures did nothing to restore sight but they did succeed in removing the flawed lens, allowing at least for the patient to have a modicum of sight. And while cataract extraction procedures were being carried out in Western Europe in 1748 in France, it was 200 years later before the modern lens replacement procedure was first carried out. British ophthalmologist Sir Harold Ridley observed while working in an RAF hospital during World War II that the acrylic material from which aircraft canopies were made, were inert when a pilot sustained an injury to his eye. In 1949, he successfully implanted an intraocular lens into the eye in a procedure that shocked many of the ophthalmic profession. The lens itself was made of perspex, an acrylic plastic material that match the canopy plastic. However, the shock with which this procedure was met, mean that it won little support and instead was viewed suspiciously. But Ridley had some support and carried on research and development, and in 1952 the first lens replacement procedure in the US was performed. The Modern Era It was not until the 1970s that the procedure began to come into favour, mainly though the development of equipment and techniques that allowed for a safe and altogether more convincing outcome. One of the biggest developments was phacoemulsification, a technique that broke up the cataract lens though the use of ultrasonic waves.
The new technique was introduced in 1967 by Charles Kelman, and it slashed the time of eye surgery drastically, while also succeeding in reducing the post operative pain that patients complained of. Today, the development of laser treatments has meant that some eye conditions can be treated even more quickly, but the only way to deal with refractive and cataract issues permanently is to have the natural crystalline lens replaced by an implant. The perspex lens version has been replaced by more flexible materials, like silicone and PMMA, while precision lens design has made it possible for the intraocular lenses to provide almost perfect sight. The lenses are even available with UV blocking substances in them to ensure a greater degree of protection is provided to the eyes themselves. And thanks to the development of these super clean intraocular lenses complications are rarer than ever before. All in all, eye correction surgery has become so precise, so clinical and so reliable that the old fears that caused such derision amongst ophthalmologists in the past have gone, and intraocular lens treatment is commonplace.
by: Kate Dawson
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