Cataract surgery: past, present and future

Abstract

PurposeSuccessful recuperation of vision of a blind eye (cataract?) after forceful rubbing of the eye (producing luxation of the lens?) has been mentioned in the Holy Bible in the 1rst Century (C.).MethodsIn the 18th C. (1789) the aspiration of cataract was considered. In the 19th C. extracapsular cataract removal was practised but the formation of secondary cataract could not be prevented. In 1917 Prof. Ignacio Barraquer developed a suction cup to remove the cataract ‘in toto’, only possible in case of mature cataract and weak zonule. In 1958 Joaquín Barraquer started to inject alphachymotrypsin into the posterior chamber for enzymatic zonulolysis permitting removal of the lens after 2 min. High optical correction was imperative.ResultsRidley recommended extracapsular extraction and introduction of a +20 D lens between the posterior capsule and the iris. Lens luxation into the vitreous cavity or the anterior chamber was a danger. Strampelli suggested a three‐point anterior chamber lens but contact with the endothelium increased the danger of corneal decompensation. Binkhorst suggested iris fixation.ConclusionsAt present, placement of the lens in the capsule, centered with the pupil, is preferred, permitting good near and distance vision without glasses.