Ancient Cataract Surgery

When did the first cataract surgery occur?

"That wasn't so bad, now, was it?"

According to the Sushruta Samhita, it was around 800 B.C.E.

This development is contemporary with the Epics of Homer, the first Olympics, India's Iron Age, the Biblical prophet Isaiah, and the adoption of the alphabet by the Greeks. 

THE FIRST OLYMPICS: 776 B.C.E.

THE BIBLICAL PROPHET ISAIAH: 8th CENTURY B.C.E.

THE EPICS OF HOMER: 8TH CENTURY B.C.E.

THE FIRST CATARACT SURGERY IS PERFORMED BY SUSHRUTA, THE "FOUNDING FATHER OF SURGERY": 800 B.C.E.

Here is a translated breakdown of the surgery provided in Duke Elder's Systems of Ophthalmology:

Preoperative care:

1) The patient was recommended to have an oily massage followed by a kind of heat-bath.

Operative technique:

1) The patient was asked to sit on a high stool, with the

surgeon sitting in front of him face to face.

2) He was instructed to look at the surgeon's nose while the operator rested his little finger on the outer eye socket bone, and held a sharp-pointed needle between his thumb, index, and middle

finger.

3) The point entered the anterior chamber, at the

junction of the medial and lateral two-thirds of the outer

portion of the white layer of the eye ball. If a sound

was produced followed by the gushing of watery fluid, then

the surgeon's needle was considered to be in the correct

part of the eye ball, but if this puncture was followed by

bleeding, it meant that it was misplaced. Care was taken

to avoid blood vessels present in that region.

4)The tip of the needle was then made to incise the capsule

of the lens.

5) With the needle in this position, the patient was

asked to blow down the nostril, while closing the opposite

side of the nose.

After this procedure, according to Sushruta, lens

material came out alongside the needle. When the

patient was able to perceive objects, the needle was

removed.

Post-operative care:

A few indigenous medicines (roots and leaves) were applied

to the eye, with a bandage. The patient was then

instructed to lie flat on his back and avoid any movement,

particularly sneezing and coughing. The operated eye was

examined daily until the tenth day. If the whitish mass

appeared again in the pupillary area the same procedure

had to be repeated.