How the Lens Came to Cataract Surgery

Many of us are familiar with the basic premise behind cataract surgery: when the lens inside of your eye gets cloudy, it's out with the old, and in with the new. Your surgeon breaks up the old lens, suctions it out, and implants a new, bright-and-shiny lens called an IOL, or Intraocular Lens.         

Both cataract surgery and lenses had LONG independent histories before they finally teamed up in 1950. It was then that they began their dual task of restoring and perfecting vision for millions of people around the world.

(This lens, the Loupe of Sargon, was fashioned in 750 BC in Assyrian Nimrud.)

Lenses begin to appear in the archaeological record as early as 750 BC, in ancient Greece, Egypt, and Babylon. These were made of polished quartz, and were used for starting fires and magnification. It is said that ancient Greeks used this technology to keep their "eternal Olympic flame" aglow by divine power.

Around the same time, cataract surgery began to appear in medical texts of India, and then of China. The procedure served only to push the cloudy lens material out of the eye, but there was nothing to replace it.

(Monet's "House Seen From the Rose Garden" after cataract surgery. Some people report that they can see ultraviolet light when the UV absorbing lens has been removed)

With no lens to replace the missing one, the eyes lose their focusing power and become very far-sighted. Obviously, this won't do if you're a painter, a surgeon, a shoemaker, or a bug collector.

(The first IOL, implanted in November 1949.)

It would be 1949 before lenses were finally modulated for use in the eye. The chosen material was deemed viable after ophthalmologists were able to observe eye injuries sustained by pilots of the Royal Air Force during World War II. Shattered pieces of Plexiglas resisted infection and remained inert inside the eyes of the wounded. Glass splinters of the same sort were rejected by the body.     

Further developments in design and technique had to come about before IOLs made their way into widespread practice. Today, tens of millions of IOLs are implanted worldwide every year.