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Surgery has been an option for about 4000 years for Cataracts


The Babylonians had some form of eye surgery that was happening at least as far back as 1750 BC. There is a record from King Hammurabi who enacted, 282 laws, from which number 215 states,

If a surgeon has operated with the bronze lancet on a patrician for a serious injury, and has cured him, or has removed with a bronze lancet a cataract for a patrician, and has cured his eye, he shall take ten shekels of silver.

About 800BC in India, they started treating cataracts with a technique called “couching”. At first, the lens had become sufficiently hard; they would strike the eye hard enough to break the supporting membranes (zonules) holding it in place to allow a person to have limited unfocused vision. Later on, they improved it by inserting a sharp object to break the zonules and push the lens out of the way. Surprisingly, in 2010 in Africa, an ophthalmologist saw a person who had had this procedure done to them and had presented with worsening vision and pain. The patient had seen someone who advertised that he could fix cataracts without the need for surgery or even a clinic. He was so blind at the time he was seen that he was only able to differentiate light from dark. He had complications – raised eye pressure, and his optic nerve almost destroyed. Unfortunately, the only thing they could do at that stage was pain relief. Not the best option.

The Romans recorded in 29AD various treatments for a range of eye conditions (besides cataracts, they treated things like short-sightedness and conjunctivitis) They would use a variety of needles (some instruments are almost identical to modern ones) to break up and suck out pieces of the lens and cauterize the wound. They would also hit the patient in the head to assist removing the cataract pieces. What is worse, someone back then poking a sharp object into your eye or hitting you in the head while the sharp object is in your eye. Unfortunately, they were unable to replace it with anything, unlike today.

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About 200 years later, the Greeks have been attributed (by a Persian doctor Muhammad ibn Zakariya al-Razi about 600 years later) with a procedure which required an assistant with a large lung capacity to suck out the affected lens. In the 10th century, an Iraqi doctor also detailed case histories from successful procedures using this method.

It was not till 1747/48, a French doctor Jacques Daviel, performed the first modern extra-capsular cataract extraction. The patients were required to lie with sand bags around their head until the wound had healed due to there being no sutures.


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