За перлата на офталмологията или кратка история на операциите за катаракта
The pearl of Ophthalmology. The evolution of cataract surgery

Summary/Abstract: Cataract is an ancient disease, with evidence of it recently been discovered in a wooden statue of an Egyptian priest from 2457-2467 B.C. Its management has perplexed physicians since antiquity as they struggled to develop an understanding of the scientific basis of the disease. The earliest known manuscript establishing standards for the payment, medical ethics and negligence settlement in ocular surgery was the Code of Hammurabi (around 1792- 1750 B.C.). The first documented cataract operation was couching. It was practiced in India, Mesopotamia and the Middle East and was introduced in ancient Europe in the 2nd century B.C., however the technique resulted in multiple complications and unsatisfactory visual gain. Jacques Daviel (1696-1762) was a French ophthalmologist credited with originating the first significant advance in cataract surgery since couching was invented in ancient India. Daviel performed the first extracapsular cataract extraction on 8 April 1747 which remained standard practice for more than 200 years. With the advent of disinfection, sterilization and anaesthesia the introduction of suturing in both the East and the West the procedure became safer and less traumatic. Sir Nicholas Harold Lloyd Ridley (1906-2001) was an English ophthalmologist who invented the intraocular lens and pioneered intraocular lens surgery for cataract patients. Charles D. Kelman, MD (1930-2004) devised the technique that ultimately became phacoemulsification and reported it in 1967. Phacoemulsification has evolved into the most significant advance in ophthalmic surgery. This procedure combined with intraocular lens implantation is the most successful rehabilitative procedure in all of medicine. Dr Kelman led ophthalmology to adopt the concept of small-incision surgery, which resulted in shortened hospital stays and a rapid return to normal activities.

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